Treatment with PCSK9 inhibitors reduces atherogenic VLDL remnants in a real-world study
Background - Proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9-I) reduce low-density lipoprotein (LDL) cholesterol in human studies. Previous studies suggest that PCSK9-I may also affect very-low-density lipoproteins (VLDL). We therefore studied VLDL size and composition in a “real-wor...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
23 March 2019
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| In: |
Vascular pharmacology
Year: 2019, Volume: 116, Pages: 8-15 |
| ISSN: | 1879-3649 |
| DOI: | 10.1016/j.vph.2019.03.002 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.vph.2019.03.002 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S1537189118304385 
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| Author Notes: | Tim Hollstein, Anja Vogt, Thomas Grenkowitz, Tatjana Stojakovic, Winfried März, Ulrich Laufs, Bediha Bölükbasi, Elisabeth Steinhagen-Thiessen, Hubert Scharnagl, Ursula Kassner |
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| 520 | |a Background - Proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9-I) reduce low-density lipoprotein (LDL) cholesterol in human studies. Previous studies suggest that PCSK9-I may also affect very-low-density lipoproteins (VLDL). We therefore studied VLDL size and composition in a “real-world” study population with the use of β-quantification. - Subjects and methods - 350 patients (62±11years old, 58% men, 22% with diabetes mellitus) with different concomitant lipid lowering therapies, and in whom PCSK9-I treatment was indicated, received either evolocumab (140mg) or alirocumab (75 or 150mg). The major lipoprotein fractions were separated by β-quantification and lipid and apolipoprotein compositions were determined before and 4weeks after initiation of PCSK9-I treatment. - Results - After 4weeks of PCSK9-I treatment, the ratio of triglycerides to apolipoprotein B in VLDL particles (VLDL-TG/apoB ratio) increased by 40% (p<.0001). VLDL-associated apolipoproteins E, CII, and CIII were reduced by 29.4%, 16.4%, and 12.4%, respectively (all p<.0001). - Conclusion - PCSK9-I treatment increased VLDL size (estimated by an increased VLDL-TG/apoB ratio) and reduced VLDL-associated apolipoproteins in a heterogeneous “real-world” study-population, reflecting a higher clearance of small atherogenic VLDL remnant particles by PCSK9-I. This may potentially lower cardiovascular risk in clinical routine patients beyond low-density cholesterol (LDL-C) reduction. | ||
| 650 | 4 | |a Alirocumab | |
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| 650 | 4 | |a Lipoproteins | |
| 650 | 4 | |a PCSK9 inhibitor | |
| 650 | 4 | |a VLDL remnants | |
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