Clinical effect of proprotein convertase subtilisin/kexin type 9 inhibitor combined with atorvastatin in treatment of intracranial atherosclerotic stenosis
10.19845/j.cnki.zfysjjbzz.2024.0068
- VernacularTitle:PCSK9抑制剂联合阿托伐他汀对颅内动脉粥样硬化性狭窄的治疗效果
- Author:
Qunliang HU
1
Author Information
1. Department of Brain， Tianjin Beichen Hospital， Tianjin 300400， China
- Publication Type:Journal Article
- Keywords:
PCSK9 inhibitor;
Statins;
Intracranial atherosclerosis;
High‑resolution MRI
- From:
Journal of Apoplexy and Nervous Diseases
2024;41(4):349-354
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of proprotein convertase subtilisin/kexin type 9 inhibitor （PCSK9） combined with atorvastatin on intracranial plaque in patients with intracranial atherosclerotic stenosis （ICAS）. Methods A prospective study was performed for the imaging and clinical data of ICAS patients who were admitted to Tianjin Beichen Hospital from January 2022 to April 2023 and received atorvastatin with or without PCSK9 inhibitor. The patients in the atorvastatin group received treatment with atorvastatin 10-40 mg per day， once a day， and those in the PCSK9 inhibitor group received 140 mg evolocumab injection， once every two weeks， in addition to the treatment in the atorvastatin group. The two groups were compared in terms of HR-MRI imaging findings and blood lipid levels before treatment and after 12 weeks of treatment， as well as major vascular events and adverse drug reactions during treatment. Results A total of 98 patients were enrolled， with 46 in the atorvastatin group and 52 in the PCSK9 inhibitor group. There were no significant differences in blood lipid levels and HR-MRI parameters between the two groups at baseline. From baseline to after 12 weeks of treatment， the PCSK9 inhibitor group had significant reductions in the levels of total cholesterol （TC）， triglyceride， and low-density lipoprotein （LDL）（all P<0.001）， while the atorvastatin group only had significant reductions in the levels of TC and LDL （both P<0.001）， and the PCSK9 inhibitor group had significantly lower levels of TC and LDL than the atorvastatin group （both P<0.001）. From baseline to after 12 weeks of treatment， the PCSK9 inhibitor group had significant reductions in arterial stenosis rate and standardized wall index （both P=0.001）， while the atorvastatin group had no significant changes in HR-MRI parameters （all P>0.05）. After 12 weeks of treatment， the PCSK9 inhibitor group had a significantly higher proportion of patients with good treatment response than the atorvastatin group （75.00% vs 45.65%， χ2=8.885， P=0.003）. Conclusion The combination of PCSK9 inhibitor and atorvastatin can not only reduce level of LDL in ICAS patients， but also reduce the degree of stenosis， with relatively high safety.
- Full text:2025071008380946380PCSK9抑制剂联合阿托伐他汀对颅内动脉粥样硬化性狭窄的治疗效果.pdf
