Eligibility for PCSK9 inhibitors based on the 2019 ESC/EAS and 2018 ACC/AHA guidelines.

Détails

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Etat: Public
Version: de l'auteur⸱e
Licence: Non spécifiée
ID Serval
serval:BIB_93EA67EF9F1C
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Eligibility for PCSK9 inhibitors based on the 2019 ESC/EAS and 2018 ACC/AHA guidelines.
Périodique
European journal of preventive cardiology
Auteur⸱e⸱s
Koskinas K.C., Gencer B., Nanchen D., Branca M., Carballo D., Klingenberg R., Blum M.R., Carballo S., Muller O., Matter C.M., Lüscher T.F., Rodondi N., Heg D., Wilhelm M., Räber L., Mach F., Windecker S.
ISSN
2047-4881 (Electronic)
ISSN-L
2047-4873
Statut éditorial
Publié
Date de publication
23/03/2021
Peer-reviewed
Oui
Volume
28
Numéro
1
Pages
59-65
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
The 2018 American College of Cardiology (ACC)/American Heart Association (AHA) and 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) lipid guidelines recently updated their recommendations regarding proprotein convertase subtilisin/kexin-9 inhibitors (PCSK9i). We assessed the potential eligibility for PCSK9i according to the new guidelines in patients with acute coronary syndromes.
We analysed a contemporary, prospective Swiss cohort of patients hospitalised for acute coronary syndromes. We modelled a statin intensification effect and an incremental ezetimibe effect on low-density lipoprotein-cholesterol levels among patients who were not on high-intensity statins or ezetimibe. One year after the index acute coronary syndrome event, treatment eligibility for PCSK9i was defined as low-density lipoprotein-cholesterol of 1.4 mmol/l or greater according to ESC/EAS guidelines. For ACC/AHA guidelines, treatment eligibility was defined as low-density lipoprotein-cholesterol of 1.8 mmol/l or greater in the presence of very high-risk atherosclerotic cardiovascular disease, defined by multiple major atherosclerotic cardiovascular disease events and/or high-risk conditions. Of 2521 patients, 93.2% were treated with statins (53% high-intensity statins) and 7.3% with ezetimibe at 1 year, and 54.9% had very high-risk atherosclerotic cardiovascular disease. Low-density lipoprotein-cholesterol levels less than 1.8 mmol/l and less than 1.4 mmol/l at 1 year were observed in 37.5% and 15.7% of patients, respectively. After modelling the statin intensification and ezetimibe effects, these numbers increased to 76.1% and 49%, respectively. The proportion of patients eligible for PCSK9i was 51% according to ESC/EAS criteria versus 14% according to ACC/AHA criteria.
In this analysis, the 2019 ESC/EAS guidelines rendered half of all post-acute coronary syndrome patients potentially eligible for PCSK9i treatment, as compared to a three-fold lower eligibility rate based on the 2018 ACC/AHA guidelines.
Mots-clé
Atherosclerosis, Cardiology, Cardiovascular Diseases, Europe, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, PCSK9 Inhibitors/therapeutic use, Practice Guidelines as Topic, Proprotein Convertase 9, Prospective Studies, Societies, Medical, United States, Lipids, PCSK9 inhibitors, ezetimibe, secondary prevention, statins
Pubmed
Web of science
Création de la notice
24/07/2020 14:02
Dernière modification de la notice
24/08/2024 7:15
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