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).
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A question that remains unclear, however, is whether these therapies reduce mortality
in high-risk patients on background statin therapy.To read this article in full you will need to make a payment
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References
- Alirocumab and cardiovascular outcomes after acute coronary syndrome.N Engl J Med. 2018; 379: 2097-2107
- Evolocumab and clinical outcomes in patients with cardiovascular disease.N Engl J Med. 2017; 376: 1713-1722
- Association of baseline LDL-C with Total and cardiovascular mortality in patients using proprotein convertase subtilisin-kexin type 9 inhibitors: a systematic review and meta-analysis.J Clin Lipidol. 2019; https://doi.org/10.1016/j.jacl.2019.05.014
- Association between baseline LDL-C level and total and cardiovascular mortality after LDL-C lowering: a systematic review and meta-analysis.JAMA. 2018; 319: 1566-1579
- Low LDL cholesterol by PCSK9 variation reduces cardiovascular mortality.J Am Coll Cardiol. 2019; 73: 3102-3114
- Effect of alirocumab on mortality after acute coronary syndromes: an analysis of the ODYSSEY OUTCOMES randomized clinical trial.Circulation. 2019; 140: 103-112
- 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol.Circulation. 2019; 139: e1082-e1143
Article info
Publication history
Published online: July 04, 2019
Footnotes
The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
Sources of funding: This work was supported by research funding from the Department of Veterans Affairs Health Services Research & Development (IIR 16-072). This work was also supported by the Houston VA HSR&D Center for Innovations grant (HFP 90-020).
Financial Disclosures: Dr Virani has received honorarium from the American College of Cardiology (Associate Editor for Innovations, acc.org). He also serves on the steering committee for the Patient and Provider Assessment of Lipid Management (PALM) registry at the Duke Clinical Research Institute (no financial remuneration).
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Copyright
Published by Elsevier Inc. on behalf of National Lipid Association.
