Impact of PCSK9 inhibitors on coronary atheroma phenotype following myocardial infarction: insights from intravascular imaging.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Opinion in Cardiology Pub Date : 2023-11-01 Epub Date: 2023-09-25 DOI:10.1097/HCO.0000000000001080

Timothy Abrahams, Masashi Fujino, Adam J Nelson, Stephen J Nicholls

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引用次数: 0

Abstract

Purpose of review: The aim of this study was to review the impact of combination lipid lowering with statins and proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors on coronary atherosclerosis using serial intravascular imaging.

Recent findings: Early studies using intravascular ultrasound established the ability of increasingly intensive lipid lowering to both slow progression and ultimately promote regression of coronary disease. More recent clinical trials that have employed serial imaging with optical coherence tomography have permitted the ability to evaluate the impact of intensive lipid lowering on compositional features associated with plaque vulnerability. In particular, the combination of intensive statin and PCSK9 inhibitor therapy promotes plaque stability in patients following an acute coronary syndrome.

Summary: More intensive lipid lowering using the combination of statins and PCSK9 inhibitors promote plaque regression in addition to promoting calcification, fibrous cap thickening and reductions in plaque lipid. These plaque-stabilizing effects underscore the benefits of combination therapy on cardiovascular events and highlight the importance of combination lipid-lowering therapy.

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PCSK9抑制剂对心肌梗死后冠状动脉粥样硬化表型的影响：来自血管内成像的见解。

综述目的：本研究的目的是通过系列血管内成像，综述他汀类药物和前蛋白转化酶枯草杆菌蛋白酶9型（PCSK9）抑制剂联合降脂对冠状动脉粥样硬化的影响。最近的发现：使用血管内超声的早期研究表明，越来越强烈的降脂能够减缓冠状动脉疾病的进展并最终促进其消退。最近的临床试验采用了光学相干断层扫描的系列成像，使其能够评估强化降脂对与斑块脆弱性相关的成分特征的影响。特别是，强化他汀类药物和PCSK9抑制剂的联合治疗可促进急性冠状动脉综合征患者的斑块稳定性。总结：使用他汀类药物和PCSK9抑制剂的组合进行更深入的降脂，除了促进钙化、纤维帽增厚和斑块脂质减少外，还能促进斑块消退。这些斑块稳定作用强调了联合治疗对心血管事件的益处，并强调了联合降脂治疗的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Cardiology 医学-心血管系统

CiteScore

4.20

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.