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Mortality reduction with PCSK9 inhibition: A case of cautious optimism

  • Dave L. Dixon
    Affiliations
    Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA, USA
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  • Salim S. Virani
    Correspondence
    Corresponding author. Health Services Research and Development, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA.
    Affiliations
    Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations, Houston, TX, USA
    Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine, Houston, TX, USA
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      The advent of monoclonal antibodies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) has been a great achievement in clinical lipidology and cardiovascular medicine. Both alirocumab and evolocumab have been shown to significantly reduce cardiovascular events and are generally well tolerated, even in patients who achieve very low levels of low-density lipoprotein cholesterol (LDL-C).
      • Schwartz G.G.
      • Steg P.G.
      • Szarek M.
      • et al.
      Alirocumab and cardiovascular outcomes after acute coronary syndrome.
      • Sabatine M.S.
      • Giugliano R.P.
      • Keech A.C.
      • et al.
      Evolocumab and clinical outcomes in patients with cardiovascular disease.
      A question that remains unclear, however, is whether these therapies reduce mortality in high-risk patients on background statin therapy.
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