The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis
Abstract. Background. Proprotein convertase subtilisin/kexin 9 (PSCK9) inhibitors have been beneficial for many patients with hyperlipidemia. The objective of this study was to investigate the benefit of PSCK9 inhibitors in patients with acute coronary syndrome (ACS). Methods. We systematically sear...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health/LWW
2024-03-01
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| Series: | Emergency and Critical Care Medicine |
| Online Access: | http://journals.lww.com/10.1097/EC9.0000000000000108 |
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| author | Guanzhao Zhang Shuting Chang Faming Zhao Xiangfeng Guan Zifan Nie Wenhao Liu Bo Li |
| author_facet | Guanzhao Zhang Shuting Chang Faming Zhao Xiangfeng Guan Zifan Nie Wenhao Liu Bo Li |
| author_sort | Guanzhao Zhang |
| collection | DOAJ |
| description | Abstract. Background. Proprotein convertase subtilisin/kexin 9 (PSCK9) inhibitors have been beneficial for many patients with hyperlipidemia. The objective of this study was to investigate the benefit of PSCK9 inhibitors in patients with acute coronary syndrome (ACS).
Methods. We systematically searched PubMed, EMBASE, and Cochrane Clinical Trials (published before January 2023; no language restriction) to compare the treatment of patients with ACS using PCSK9 inhibitors and placebo. The primary end points were major adverse cardiovascular events, nonfatal myocardial infarction, cardiogenic death, stroke, hospitalization for recurrent ACS, and coronary revascularization. Fixed- or random-effects models were used to assess the aggregated data.
Results. Of the 1686 identified studies, 5 were eligible and included in our analysis (of a total of 38,005 participants, 18,609 cases were placed in the PCSK9 inhibitor treatment group and 19,396 cases in the placebo group). Compared with the placebo group, PCSK9 inhibitors significantly reduced the major adverse cardiovascular events (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.77–0.88; P < 0.00001) for patients following ACS. The incidence of nonfatal myocardial infarction (relative risk: 0.80; 95% CI: 0.74–0.87; P < 0.00001), cardiovascular death (OR: 0.96; 95% CI: 0.83–1.10; P = 0.56), stroke (OR: 0.74; 95% CI: 0.63–0.88; P = 0.0007), hospitalization for recurrent ACS (OR: 0.57; 95% CI: 0.40–0.83; P = 0.003), or coronary revascularization (OR: 0.82; 95% CI: 0.76–0.88; P < 0.00001) all demonstrated a significant decrease in the comparison between the 2 groups.
Conclusion. This meta-analysis demonstrated that treatment with PCSK9 inhibitors in patients with ACS reduced the probability of multiple cardiovascular events and improved patient prognosis. |
| format | Article |
| id | doaj-art-e20d664905db4d87bd43ed244adf252c |
| institution | DOAJ |
| issn | 2097-0617 2693-860X |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Emergency and Critical Care Medicine |
| spelling | doaj-art-e20d664905db4d87bd43ed244adf252c2025-08-20T03:17:54ZengWolters Kluwer Health/LWWEmergency and Critical Care Medicine2097-06172693-860X2024-03-0141283410.1097/EC9.0000000000000108202403000-00005The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysisGuanzhao Zhang0Shuting Chang1Faming Zhao2Xiangfeng Guan3Zifan Nie4Wenhao Liu5Bo Li6a Department of Cardiology, Binzhou Medical University, Zibo Central Hospital, Zibo, Shandong, Chinab Weifang Medical University, Weifang, Shandong, Chinac Department of Infectious Disease, Zibo Infectious Disease Hospital, Zibo, Shandong, China.b Weifang Medical University, Weifang, Shandong, Chinaa Department of Cardiology, Binzhou Medical University, Zibo Central Hospital, Zibo, Shandong, Chinaa Department of Cardiology, Binzhou Medical University, Zibo Central Hospital, Zibo, Shandong, Chinaa Department of Cardiology, Binzhou Medical University, Zibo Central Hospital, Zibo, Shandong, ChinaAbstract. Background. Proprotein convertase subtilisin/kexin 9 (PSCK9) inhibitors have been beneficial for many patients with hyperlipidemia. The objective of this study was to investigate the benefit of PSCK9 inhibitors in patients with acute coronary syndrome (ACS). Methods. We systematically searched PubMed, EMBASE, and Cochrane Clinical Trials (published before January 2023; no language restriction) to compare the treatment of patients with ACS using PCSK9 inhibitors and placebo. The primary end points were major adverse cardiovascular events, nonfatal myocardial infarction, cardiogenic death, stroke, hospitalization for recurrent ACS, and coronary revascularization. Fixed- or random-effects models were used to assess the aggregated data. Results. Of the 1686 identified studies, 5 were eligible and included in our analysis (of a total of 38,005 participants, 18,609 cases were placed in the PCSK9 inhibitor treatment group and 19,396 cases in the placebo group). Compared with the placebo group, PCSK9 inhibitors significantly reduced the major adverse cardiovascular events (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.77–0.88; P < 0.00001) for patients following ACS. The incidence of nonfatal myocardial infarction (relative risk: 0.80; 95% CI: 0.74–0.87; P < 0.00001), cardiovascular death (OR: 0.96; 95% CI: 0.83–1.10; P = 0.56), stroke (OR: 0.74; 95% CI: 0.63–0.88; P = 0.0007), hospitalization for recurrent ACS (OR: 0.57; 95% CI: 0.40–0.83; P = 0.003), or coronary revascularization (OR: 0.82; 95% CI: 0.76–0.88; P < 0.00001) all demonstrated a significant decrease in the comparison between the 2 groups. Conclusion. This meta-analysis demonstrated that treatment with PCSK9 inhibitors in patients with ACS reduced the probability of multiple cardiovascular events and improved patient prognosis.http://journals.lww.com/10.1097/EC9.0000000000000108 |
| spellingShingle | Guanzhao Zhang Shuting Chang Faming Zhao Xiangfeng Guan Zifan Nie Wenhao Liu Bo Li The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis Emergency and Critical Care Medicine |
| title | The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis |
| title_full | The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis |
| title_fullStr | The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis |
| title_full_unstemmed | The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis |
| title_short | The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis |
| title_sort | benefits of pcsk9 inhibitors in patients with acute coronary syndrome a systematic review and meta analysis |
| url | http://journals.lww.com/10.1097/EC9.0000000000000108 |
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