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Real world effectiveness of pcsk-9 inhibitors combined with statins versus statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease in China(rwe-pcsk study)

引用

Journal of Geriatric Cardiology 2021年第4期18卷 261-270页

作者： Yu-Qi LIU Dan-Dan LI Meng CHAI Hong-Liang CONG Xiao-Qiang CONG Jun DAI Rong-Pin DU Ming GAO Jin-Cheng GUO Yan-Qing GUO Xiao-Jian HONG Rong-Chong HUANG Feng-Shun JIA Jia-Yu LI Qing LI Jia-Mei LIU Xin-Ping LIU Yu-Guo LIU Hong-Gang NIE Bing SHAO Xiao-Yu SHEN Hai-Qing SONG Yi-Jun SONG Li-Jun WANG Shuo WANG Dong-Mei WU Jing XIA Zhi-Yong YANG Hong-Ying YU Hui ZHANG Tie-Mei ZHANG Ji-Yi ZHAO Liang-Chen ZHAO Ming-Qi ZHENG Yun-Dai CHEN Department of Cardiology Chinese PLA General HospitalBeijingChina Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic DiseaseClinical Center for Coronary Heart DiseaseCapital Medical UniversityBeijingChina Department of Cardiology Tianjin Chest HospitalTianjinChina Department of Cardiology the First Hospital of Jilin UniversityChangchunChina Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Hebei People’s HospitalShijiazhuangChina Department of Cardiology Kailuan General HospitalHebei Union UniversityTangshanChina Department of Cardiology Beijing Luhe HospitalCapital Medical UniversityBeijingChina Department of Cardiology Shanxi Cardiovascular HospitalTaiyuanChina Department of Cardiology the Fourth Affiliated Hospital of Harbin Medical UniversityHarbinChina Department of Cardiology Beijing Friendship HospitalCapital Medical UniversityBeijingChina Department of Cardiology Tangshan Worker’s HospitalTangshanChina Department of Cardiology China-Japan Friendship Hospital Affiliated Jilin UniversityChangchunChina Department of Cardiology Handan Central HospitalHebeiChina Heart Center Beijing Key Laboratory of HypertensionBeijing Chao-Yang HospitalCapital Medical UniversityBeijingChina Department of Cardiology the First Affiliated Hospital of Dalian Medical UniversityLiaoningChina Department of Cardiology the Second Affiliated Hospital of Harbin Medical UniversityHarbinChina Department of Cardiology the Second Affiliated Hospital of Shenyang Medical CollegeShenyangChina Department of Cardiology the Second Hospital of Shanxi Medical UniversityTaiyuanChina Department of Neurology Xuanwu Hospital Capital Medical UniversityBeijingChina Department of Neurology Tianjin Medical University Gen

BACKGROUND The efficacy and safety of proprotein convertase subtilisin/kexin type 9(pcsk-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not been evaluated. This study aims to describe the real world effectiveness of pcsk-9 inhibitors combined with statins compared with statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease(ASCVD).METHODS This is a multi-center observational study, enrolled patients from 32 hospitals who underwent percutaneous coronary intervention(PCI) from January to June in 2019. There are 453 patients treated with pcsk-9 inhibitors combined with statins in pcsk-9 inhibitor group and 2,610 patients treated with statins-based lipid lowering therapies in statins-based group. The lipid control rate and incidence of major adverse cardiovascular events(MACE) over six months were compared between two groups.A propensity score-matched(PSM) analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for *** In a total of 3,063 patients, 89.91% of patients had received moderate or high-intensity statins-based therapy before PCI, but only 9.47% of patients had low-density lipoprotein cholesterol(LDL-C) levels below 1.4 mmol/L at baseline. In the PSM selected patients, LDL-C level was reduced by 42.57% in pcsk-9 inhibitor group and 30.81%(P pcsk-9 inhibitor group and 0.23% to 6.11% in statins-based group, and the proportion of LDL-C ≤ 1.4 mmol/L increased from 10.36% to 47.69% in pcsk-9 inhibitor group and 2.99% to 18.43% in statins-based group(P pcsk-9 inhibitor and statins-based treatment in reducing the risk of MACE(hazard ratio = 2.52, 95% CI: 0.49-12.97, P = 0.250).CONCLUSIONS In the real

关键词： LDL rwe-pcsk study Real world effectiveness of pcsk-9 inhibitors combined with statins versus statins-based therapy among patients with very high r

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