Effect of PCSK9 inhibitors on remnant cholesterol and lipid residual risk: The LIPID-REAL registry
Por:
Cordero A, Fernández Del Olmo MR, Cortez Quiroga GA, Romero-Menor C, Fácila L, Seijas-Amigo J, Rondán Murillo J, Sandin M, Rodríguez-Mañero M, Bello Mora MC, Valle A, Fornovi A, Freixa Pamias R, Bañeras J, Blanch García P, Clemente Lorenzo MM, Sánchez-Álvarez S, López-Rodríguez L and González-Juanatey JR
Publicada:
1 dic 2022
Ahead of Print:
1 sep 2022
Resumen:
Background Monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce low-density lipoprotein cholesterol (LDLc) by 55%, regardless of baseline treatments. Nonetheless, the effect of other lipid parameters, such as cholesterol remnants or, the so-called lipid residual risk, is unknown. Methods Multicenter and retrospective registry of patients treated with PCSK9 inhibitors from 14 different hospitals in Spain. Before and on-treatment lipid parameters were recorded. Residual lipid risk was estimated by (1) cholesterol remnants, (2) triglycerides/HDLc ratio (TG/HDL), (3) total cholesterol/HDLc (TC/HDL) and (4) the triglycerides-to-glucose index (TGGi). Results Six hundred fifty-two patients were analysed, mean age of 60.2 (9.63) years, 24.69% women and mean LDLc before treatment 149.24 (49.86) mg/dl. Median time to second blood determination was 187.5 days. On-treatment LDLc was 67.46 (45.78) mg/dl, which represented a 55% reduction. Significant reductions were observed for TG/HDL ratio, cholesterol remnants, TC/HDL ratio and TGGi. As consequence, 34.61% patients had LDLc <55 mg/dl and cholesterol remnants <30 mg/dl; additionally, 31.95% had cholesterol remnants 55 mg/dl. Patients who had levels of cholesterol remnants >30 mg/dl before initiating the treatment with PCSK9 had higher reductions in cholesterol remnants, TG/HDL ratio, TC/HDL and TGGi. By contrast, no reduction differences were observed according to baseline LDLc (< or > the mean), age, gender or obesity. Conclusions This multicenter and retrospective registry of real-world patients treated with PCSK9 inhibitors demonstrates a positive effect on cholesterol remnants and lipid residual risk beyond LDLc reductions.
Filiaciones:
:
Cardiology Department. Hospital Universitario de San Juan. Alicante, Spain
Unidad de Investigación en Cardiología. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Fernández Del Olmo MR:
Cardiology Department. Complejo Hospitalario de Jaén. Jaén., Spain
Cortez Quiroga GA:
Cardiology Department. Hospital Alto Guadalquivir. Jaén., Spain
Romero-Menor C:
Cardiology Department. Parc Sanitari Sant Joan de Déu. Sant Boi de Llobregat, Barcelona, Spain
Fácila L:
Cardiology Department. Consorcio Hospital General de Valencia. Valencia., Spain
Seijas-Amigo J:
Cardiology Department. Complejo Hospitalario Universidad de Santiago de Compostela. Santiago de Compostela., Spain
Rondán Murillo J:
Cardiology Department. Hospital Universitario de Cabueñes. Gijón., Spain
Sandin M:
Cardiology Department. Hospital General Universitario de Alicante. Alicante., Spain
Rodríguez-Mañero M:
Cardiology Department. Complejo Hospitalario Universidad de Santiago de Compostela. Santiago de Compostela., Spain
Bello Mora MC:
Cardiology Department. Hospital de Alava. Vitoria., Spain
Valle A:
Cardiology Department. Hospital Universitario de Denia. Denia., Spain
:
Endocrinology Department. Hospital Vega Baja. Orihuela., Spain
Freixa Pamias R:
Cardiology Department. Hospital Sant Joan Despí Moisès Broggi. Sant Joan Despí, Barcelona, Spain
Bañeras J:
Cardiology Department. Hospital del Vall Hebrón. Barcelona., Spain
Blanch García P:
Cardiology Department. Hospital Sant Joan Despí Moisès Broggi. Sant Joan Despí, Barcelona, Spain
Clemente Lorenzo MM:
Cardiology Department. Hospital Virgen del Puerto de Plasencia. Plasencia., Spain
:
Cardiology Department. Hospital Hospital Lluis Alcanys Xátiva. Valencia., Spain
López-Rodríguez L:
Cardiology Department. Hospital Manacor. Palma de Mallorca., Spain
González-Juanatey JR:
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Cardiology Department. Complejo Hospitalario Universidad de Santiago de Compostela. Santiago de Compostela., Spain
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