Effect of PCSK9 inhibitors on inflammation levels and ventricular remodeling after PCI in ST-elevation acute myocardial infarction
10.3969/j.issn.1006-5725.2024.15.017
- VernacularTitle:PCSK9抑制剂对ST段抬高型急性心肌梗死PCI后炎症水平和心室重构的影响
- Author:
Weifeng ZHANG
1
;
Hailong MA
;
Jinling ZHANG
Author Information
1. 康复大学青岛中心医院(青岛市中心医院)急救中心(山东青岛 266043)
- Keywords:
ST-elevation acute myocardial infarction;
cardiovascular events;
PCSK9 inhibitors;
inflammatory factors;
ventricular remodeling
- From:
The Journal of Practical Medicine
2024;40(15):2142-2147
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of PCSK9 inhibitors on the level of inflammation and ven-tricular remodeling after PCI in ST-elevation acute myocardial infarction.Methods A total of 220 patients with acute ST-segment elevation myocardial infarction who received percutaneous coronary artery intervention in the Emergency Center of Qingdao Central Hospital from April 2021 to July 2023 were randomly divided into two groups,110 patients in the control group were treated with conventional treatment,and 110 patients in the PCSK9i group were treated with PCSK9 inhibitors on the basis of conventional treatment.Compared before and after treatment left ventricular endsystolic diameter(LVESD)and left ventricular ejection fraction(LVEF)and triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC).C-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis factor α(TNF-α).The incidence of major adverse cardiovascular events(MACE)(including myocardial infarction,recurrence of heart failure,malignant arrhythmia,and cardiovascular death)was compared.Results After 6 months of treatment and follow-up,LVEDD(mm),LVESD(mm),TG(mmol/L),TC(mmol/L),LDL-C(mmol/L),CRP(mg/L),TNF-α(pg/mL)and JL-6(ng/mL)after PCSK9i treatment were significantly lower than those in the control group,and the difference was statistically significant[(51.32±5.84)vs.(54.43±2.91);(34.88±2.69)vs.(36.96±3.19);(1.41±0.61)vs.(2.13±1.26);(3.53±1.06)vs.(3.98±0.93);(0.95±0.36)vs.(1.79±0.27);(5.18±1.92)vs.(7.69±2.61);(36.43±9.41)vs.(57.79±14.43);(17.4±0.68)vs.(28.55±8.92),All P<0.01],and the LVEF(%)and HDL-C(mmol/L)in the PCSK9i group were higher than patients in the control group,and the difference was statistically significant[(46.69±3.63)vs.(41.34±3.42),P<0.05,(1.35±0.29)vs.(1.29±0.27),P<0.01].The incidence of MACE events in the PCSK9i group was obviously lower than patients in the control group(5.2%vs.13.6%,P<0.05).Conclusion The application of PCSK9 inhibitors after PCI in patients with ST-segment elevation acute myocardial infarction can better reduce blood lipids,stabilize coronary plaque,reduce local and circula-tory inflammatory responses after myocardial infarction,improve ventricular adverse remodeling after myocardial infarction,inhibit ventricular remodeling,and reduce the total incidence of MACE,worthing promoting use.
