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Atherosclerosis stabilization with PCSK-9 inhibition: An evolving concept for cardiovascular prevention
Journal article   Open access   Peer reviewed

Atherosclerosis stabilization with PCSK-9 inhibition: An evolving concept for cardiovascular prevention

Jennifer G Robinson, Donald D Heistad and Keith A.A Fox
Atherosclerosis, Vol.243(2), pp.593-597
12/2015
DOI: 10.1016/j.atherosclerosis.2015.10.023
PMID: 26545013
url
https://www.research.ed.ac.uk/en/publications/9ecda163-b207-4762-bd0f-2e541136736eView
Open Access

Abstract

Monoclonal antibodies (mAbs) to proprotein convertase subtilisin/kexin type 9 (PCSK-9) can further lower LDL-C by ≥60% in statin-treated patients. Preliminary data suggest they may reduce cardiovascular (CVD) events. Ongoing PCSK-9 mAb cardiovascular outcomes trials could provide the opportunity to determine whether a “legacy effect” similar to that observed for statins will occur over the post-trial observation period. We hypothesize these trials could demonstrate that (1) very aggressive LDL-C lowering with PCSK-9 mAbs added to background statin therapy will induce extensive atherosclerosis stabilization and regression in the large majority of treated patients, and (2) continued maintenance therapy with high intensity statin therapy (with or without ezetimibe) should then inhibit new plaque formation, with a long-term prevention of CVD events. The necessity of expensive lifetime treatment with PCSK-9 inhibitors could then be avoided in all but a small subset of patients who could benefit from longer treatment.
Regression Cardiovascular prevention Statin PCSK-9 inhibitor Plaque stabilization

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