Rationale for Early Administration of PCSK9 Inhibitors in Acute Coronary Syndrome

Salvatore Giordano; Jessica Ielapi; Nadia Salerno; Angelica Cersosimo; Alessandro Lucchino; Alessandro Laschera; Giovanni Canino; Assunta Di Costanzo; Salvatore De Rosa; Daniele Torella; Sabato Sorrentino

doi:10.31083/j.rcm2510374

Rationale for Early Administration of PCSK9 Inhibitors in Acute Coronary Syndrome

Rev Cardiovasc Med. 2024 Oct 22;25(10):374. doi: 10.31083/j.rcm2510374. eCollection 2024 Oct.

Affiliations

¹ Department of Medical and Surgical Sciences, Division of Cardiology, "Magna Graecia" University, 88100 Catanzaro, Italy.
² Department of Experimental and Clinical Medicine, "Magna Graecia" University, 88100 Catanzaro, Italy.

Abstract

Acute coronary syndromes (ACSs) represent a significant global health challenge arising from atherosclerotic cardiovascular disease (ASCVD), with elevated low-density lipoprotein cholesterol (LDL-C) levels being a primary contributor. Despite standard statin therapy, individuals with ACS remain at high risk for recurrent cardiovascular events, particularly in the initial post-ACS period. Monoclonal antibodies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9), such as evolocumab and alirocumab, offer a potential strategy to reduce LDL-C levels further and mitigate this residual risk. This review delves into the molecular mechanisms, effects on cholesterol metabolism, inflammatory modulation, and clinical outcomes associated with early administration of PCSK9 inhibitors following ACS.

Keywords: acute coronary syndrome; low-density lipoprotein cholesterol; proprotein convertase subtilisin/kexin type 9.

Publication types

Review