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Inclisiran in Dyslipidemia with High Residual Platelet Reactivity
Dina Kapsultanova1, Sholpan Zhangelova1, Friba Nurmukhammad2
1Faculty of Postgraduate Education, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan.
Diseases (Basel, Switzerland)
|January 27, 2026
Summary
Inclisiran effectively lowers LDL-C and may improve platelet reactivity in high-risk patients with dyslipidemia and high residual platelet reactivity (HRPR) despite standard therapies. Further research is needed to confirm clinical outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Vascular Biology
Background:
- High residual platelet reactivity (HRPR) and persistent dyslipidemia are key challenges in cardiovascular risk management, especially post-revascularization.
- Many patients fail to meet low-density lipoprotein cholesterol (LDL-C) targets or achieve adequate platelet inhibition with current treatments.
- Inclisiran, a novel siRNA targeting PCSK9, offers a new therapeutic avenue for sustained LDL-C reduction.
Purpose of the Study:
- To review the efficacy of inclisiran in patients with dyslipidemia and HRPR who have an insufficient response to conventional therapies.
- To explore the potential impact of inclisiran on platelet reactivity in high-risk cardiovascular patients.
- To highlight the role of platelet function assessment in identifying residual thrombotic risk.
Main Methods:
- A narrative literature review (2009-2025) was conducted using major scientific databases (PubMed, Scopus, Web of Science, MEDLINE).
- Included studies focused on inclisiran's addition to standard lipid-lowering therapy in patients with dyslipidemia and HRPR, assessed via the VerifyNow assay.
- Real-world clinical cases from Kazakhstan were analyzed to illustrate treatment effects.
Main Results:
- Inclisiran consistently achieves significant and sustained reductions in LDL-C and PCSK9 levels.
- Emerging data suggest inclisiran may indirectly modulate platelet reactivity, particularly in patients with extreme cardiovascular risk.
- In patients post-CABG or with extensive CAD, inclisiran showed marked LDL-C reduction and a trend towards normalized platelet reactivity.
Conclusions:
- The VerifyNow assay can aid in identifying residual thrombotic risk in patients with advanced atherosclerotic disease.
- Inclisiran shows promise as an adjunctive therapy for dyslipidemic patients with persistent cardiovascular risk and HRPR.
- Further prospective studies are essential to elucidate the interplay between LDL-C reduction, platelet function, and clinical outcomes.
Keywords:
LDL cholesterolfamilial hypercholesterolemiahigh residual platelet reactivityinclisiranplatelet function testingrevascularizationMore Related Videos
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