In-Hospital Use of PCSK9 Inhibitors in the Post ACS Patient: What Does the Evidence Show?

Curr Atheroscler Rep. 2023 Jul;25(7):381-389. doi: 10.1007/s11883-023-01112-3. Epub 2023 May 24.

Abstract

Purpose of review: The purpose of this review is to analyze and discuss the most recent data on in hospital prescription of Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) inhibitors in patients with acute coronary syndrome (ACS).

Recent findings: Recent randomized clinical trials (RTCs) have demonstrated a beneficial effect of monoclonal antibodies (mAb) PCSK9i prescription in patients with ACS on rapid reduction of low-density lipoprotein cholesterol (LDL-C) and on coronary atherosclerosis assessed by intracoronary imaging. Additionally, the safety profile of mAb PCSK9i was confirmed in all RTCs. Available RCTs show the effectiveness and rapid achievement of LDL-C levels according to American College of Cardiology/American Heart Association and European Society of Cardiology guidelines for ACS patients. However, RCTs addressing cardiovascular outcomes of PCSK9i in-hospital initiation in ACS patients are currently ongoing.

Keywords: Acute coronary syndrome; Lipid lowering therapy; Major adverse cardiovascular events; PCSK9i.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome* / drug therapy
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use
  • Anticholesteremic Agents* / pharmacology
  • Anticholesteremic Agents* / therapeutic use
  • Cholesterol, LDL
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • PCSK9 Inhibitors
  • Proprotein Convertase 9
  • Proprotein Convertases / therapeutic use
  • Subtilisin / therapeutic use
  • United States

Substances

  • PCSK9 protein, human
  • Proprotein Convertase 9
  • PCSK9 Inhibitors
  • Cholesterol, LDL
  • Subtilisin
  • Proprotein Convertases
  • Antibodies, Monoclonal
  • Anticholesteremic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors