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Published on: January 21, 2018
Efficacy of single-dose evolocumab injection in early-phase acute myocardial infarction: a retrospective
Yongcheol Kim1, Ji Woong Roh1, Oh-Hyun Lee1
1Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin, Korea.
Insights
Evolocumab significantly enhanced low-density lipoprotein cholesterol (LDL-C) reduction in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). A single evolocumab dose led to greater LDL-C lowering and higher achievement of target levels compared to standard care.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Achieving target low-density lipoprotein cholesterol (LDL-C) < 55 mg/dL in acute myocardial infarction (AMI) is challenging with statins alone.
- Rapid LDL-C reduction is crucial in the early phase of AMI.
Purpose of the Study:
- To assess the impact of a single 140 mg evolocumab injection on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in AMI patients.
- To compare LDL-C reduction and target achievement rates between evolocumab and non-evolocumab groups.
Main Methods:
- Retrospective, single-center study.
- 95 AMI patients undergoing PCI were divided into evolocumab (n=50) and non-evolocumab (n=45) groups.
- LDL-C levels were measured at 1-3 weeks post-intervention.
Main Results:
- The evolocumab group showed a 78.4% LDL-C reduction versus 45.6% in the non-evolocumab group (p < 0.001).
- 97.7% of evolocumab patients achieved LDL-C < 55 mg/dL compared to 60.0% in the control group (p < 0.001).
- Mean difference in LDL-C reduction was -33.5% (95% CI: -42.6 to -24.5%).
Conclusions:
- Single-dose evolocumab during the peri-PCI period significantly enhances LDL-C reduction in AMI patients.
- Evolocumab facilitates higher achievement rates of target LDL-C levels in the early phase of AMI.
- Evolocumab represents a valuable therapeutic option for rapid LDL-C lowering in AMI.
Background/Aims:
Achieving rapid reduction of low-density lipoprotein cholesterol (LDL-C) levels below 55 mg/dL in patients with acute myocardial infarction (AMI) can be challenging with statins alone. This single-center, retrospective study aimed to assess the impact of single-dose injection of evolocumab 140 mg on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in patients with AMI.
Methods:
A total of 95 patients with AMI who underwent PCI were divided into the evolocumab (n = 50) and non-evolocumab (n = 45) groups.
Results:
The percentage change of LDL-C level at 1-3 weeks from baseline was 78.4 ± 13.4% reduction in the evolocumab group versus 45.6 ± 22.6% in the non-evolocumab group, with a mean difference of -33.5% between the groups (95% CI: -42.6 to -24.5%; p < 0.001). The achievement rate of LDL-C levels below 55 mg/dL at 1-3 weeks was significantly higher in the evolocumab group than in the non-evolocumab group (97.7% vs. 60.0%, p < 0.001).
Conclusion:
Patients with AMI who received single-dose injection of evolocumab 140 mg during the peri-PCI period had a significantly greater LDL-C reduction and higher proportion of patients achieved the target LDL-C level in the early phase AMI than those who did not receive evolocumab.
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