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Recurrent Acute Coronary Syndrome in Young Man with Familial Hypercholesterolemia: Efficacy of Evolocumab Add-On
Narae Kim1, Jin-Man Cho1, In-Ho Yang1
1Department of Cardiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Republic of Korea.
Biomedicines
|May 25, 2024
Summary
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors effectively reduced low-density lipoprotein cholesterol (LDL-C) in a patient with recurrent acute coronary syndrome (ACS). This lipid-lowering therapy prevented further cardiovascular disease events.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Lipid-lowering therapy is crucial for preventing cardiovascular disease recurrence in acute coronary syndrome (ACS) patients.
- Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are recommended for ACS patients with inadequately controlled low-density lipoprotein cholesterol (LDL-C) on statins and ezetimibe.
Observation:
- A 39-year-old man with unstable angina experienced recurrent ACS despite maximum-dose statin and ezetimibe therapy.
- Coronary angiography revealed a de novo lesion with plaque rupture, and LDL-C levels remained above target.
Findings:
- Addition of evolocumab (a PCSK9 inhibitor) to rosuvastatin/ezetimibe successfully lowered the patient's LDL-C to target levels.
- The patient remained free of coronary artery disease (CAD) recurrence during follow-up.
Implications:
- This case demonstrates the efficacy of PCSK9 inhibitors like evolocumab in managing high-risk ACS patients with recurrent events.
- PCSK9 inhibitors represent a valuable therapeutic option for achieving LDL-C goals and preventing CAD recurrence in challenging cases.
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