Title:PCSK9 Inhibition could be Effective for Acute Myocardial Infarction
Volume: 29
Issue: 6
Author(s): Baris Gencer*François Mach
Affiliation:
- Cardiology Division, Geneva University Hospitals, Geneva, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
Keywords:
Lipids, myocardial infarction, acute coronary syndromes, lipid-lowering, cardiovascular disease, PCSK9.
Abstract: In this review, we explore the role of PCSK9 and the inhibition of PCSK9 in
patients after acute myocardial infarction (MI). Despite the implementation of evidencebased
therapies to improve outcomes, one-year mortality remains at 12-15%, and there is
still a need to further reduce complications related to MI. Mechanistic and epidemiologic
studies have suggested that the naturally occurring PCSK9 protein increases coronary
plaque vulnerability through several pathways, including pro-inflammatory LDL-C oxidation
and direct modification of plaque composition. PCSK9 inhibitors are a class of drugs
with proven efficacy in patients with recent MI. The latest guidelines recommend the use
of PCSK9 inhibitors in patients with recent MI early in the process of care to reduce
LDL-C values and associated morbidity. The use of PCSK9 inhibition could be beneficial
for mortality reduction after an acute MI and should be tested in an appropriately powered
randomized controlled trial.