IMR Press / RCM / Volume 25 / Issue 3 / DOI: 10.31083/j.rcm2503094
Open Access Systematic Review
Efficacy and Safety of PSCK9 Inhibitors on Patients with Acute Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
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1 Graduate School, Nanjing University of Chinese Medicine, 210029 Nanjing, Jiangsu, China
2 Department of Cardiovascular, Wuxi Traditional Chinese Medicine Hospital, 214071 Wuxi, Jiangsu, China
*Correspondence: wxzy001@njucm.edu.cn (Shu Lu)
Rev. Cardiovasc. Med. 2024, 25(3), 94; https://doi.org/10.31083/j.rcm2503094
Submitted: 1 September 2023 | Revised: 8 November 2023 | Accepted: 13 November 2023 | Published: 7 March 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: PCSK9 MaB (Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitor) may reduce the occurrence of major adverse cardiovascular events (MACEs) in patients diagnosed with acute coronary syndrome (ACS). In this meta-analysis, we conducted a thorough compilation of evidence from established clinical studies to evaluate PCSK9 MaB’s capacity to control blood lipid levels and prevent MACEs in ACS patients. Methods: We conducted searches on Pubmed, Embase, the Cochrane Library, and Web of Science to identify relevant articles. Data from ACS patients were extracted using a standardized format for aggregating data. We calculated the risk ratio (RR) for MACE and assessed changes in blood lipid parameters. All statistical analyses were performed using RevMan. Results: 11 articles representing 5 trials were included in our systematic review and meta-analysis. When compared to a placebo, PCSK9 MaB significantly reduced the risk of MACEs (I2 = 0%, p = 0.63, RR [95% CI] = 0.88 [0.81, 0.97], p < 0.01) and the recurrence rate of ACS (I2 = 45%, p = 0.18, RR [95% CI] = 0.89 [0.83, 0.95], p < 0.01). Additionally, PCSK9 MaB notably reduced low-density lipoprotein cholesterol (LDL-C) levels (SMD [95% CI] = –2.12 [–2.32, –1.92], p < 0.01) and Apolipoprotein B (ApoB) levels (SMD [95% CI] = –1.83 [–2.48, –1.18], p < 0.01). Importantly, there were no significant differences in adverse reactions between the PCSK9 MaB group and the control group. Conclusions: PCSK9 MaB, whether used as a standalone treatment or in combination with other therapies, can effectively inhibit PCSK9. It substantially lowers key blood lipid parameters, including low-density lipoprotein (LDL), ApoB, and triglycerides, all without giving rise to notable safety concerns.

Keywords
PSCK9I
acute coronary syndrome
systematic review
meta-analysis
Funding
82274427/Study on the biological network integration and regulation mechanism in the treatment of dilated cardiomyopathy with Linggui Yangxin Decoction
BK20201141/Study on the mechanism of Shenqi Yangxin Decoction to improve dilated cardiomyopathy by regulating DNA methylation involving DNMT1 to inhibit pyroptosis
BK20201141/Jiangsu Provincial Natural Science Foundation Project
Figures
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