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Proprotein convertase subtilisin/kexin 9 inhibitors in reducing cardiovascular outcomes: a systematic review and

Heyue Du1,2, Xiaodan Li3, Na Su4

  • 1Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.

Heart (British Cardiac Society)
|March 8, 2019
PubMed

Insights

Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors significantly reduce major adverse cardiovascular events (MACE), myocardial infarction, and stroke risk. These findings support PCSK9 inhibitors for cardiovascular disease prevention.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Cardiovascular diseases remain a leading cause of mortality worldwide.
  • Hypercholesterolemia is a major risk factor for cardiovascular events.
  • PCSK9 inhibitors represent a novel therapeutic class for lipid management.

Purpose of the Study:

  • To systematically evaluate the efficacy of PCSK9 inhibitors in preventing major adverse cardiovascular events (MACE).
  • To assess the impact of PCSK9 inhibitors on cardiovascular mortality and morbidity.
  • To determine the overall risk reduction associated with PCSK9 inhibitor therapy.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Inclusion criteria: RCTs of PCSK9 inhibitors in patients for primary/secondary cardiovascular prevention or with hypercholesterolemia.
  • Pooled relative risks (RR) and risk differences (RD) were calculated using random-effect models. Quality of evidence assessed using GRADE.

Main Results:

  • Analysis included 54 trials with 97,910 patients.
  • PCSK9 inhibitors significantly reduced MACE (RR 0.84, RD 47 fewer/1000), non-fatal myocardial infarction (MI) (RR 0.83, RD 35 fewer/1000), and stroke (RR 0.75, RD 16 fewer/1000) with moderate-quality evidence.
  • No significant differences observed in all-cause mortality, cardiovascular death, heart failure, or unstable angina with low-quality evidence.

Conclusions:

  • PCSK9 inhibitors demonstrate significant efficacy in reducing the risk of MACE, non-fatal MI, and stroke.
  • The findings support the use of PCSK9 inhibitors as a valuable therapeutic option for high-risk cardiovascular patients.
  • Further research with low-quality evidence outcomes is warranted.
Abstract

Keywords:
cardiovascular diseaselipid-lowering drugslow-density lipoprotein cholesterolproprotein convertase subtilisin/kexin type 9 inhibitorssystematic review

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