陈伟明 1朱志栋 2王逸明 2倪唤春 2李剑 2谢坤 2赵奕凯 2施海明 2罗心平2
作者信息
- 1. 云南省丘北县人民医院心内科,文山壮族苗族自治州 663299
- 2. 复旦大学附属华山医院心内科,上海 200040
- 折叠
摘要
Abstract
AIM To compare the lipid-lowering effects of inclisiran and evolocumab combined with statins in ultra-high-risk atherosclerotic cardiovascular disease(ASCVD)patients.METHODS From July 2023 to February 2024,76 ultra-high-risk ASCVD patients were recruited in the study and divided into 3 groups based on the medication regimen:statin monotherapy group(Group A,n=33),inclisiran combined with statins group(Group B,n=23),and evolocumab combined with statins group(Group C,n=20).Levels of total cholesterol,triglycerides,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),apolipoprotein A,and lipoprotein(a),as well as quality of life,were compared among 3 groups before treatment,after 3 months of medication,and after 6 months of medication.The incidence of adverse drug reactions within 6 months of treatment was compared.RESULTS After 3 months of treatment,the reductions in LDL-C were 44.4％for Group A,51.9％for Group B,and 52.2％for Group C and the LDL-C target achievement rates were 18.2％for Group A,47.8％for Group B,and 50.0％for Group C.After 6 months of treatment,the reductions were 48.1％for Group A,59.3％for Group B,and 60.9％for Group C.The LDL-C target achievement rates were 28.3％for Group A,60.4％for Group B,and 59.8％for Group C,with LDL-C＜1.4 mmol·L-1 as the criterion.Compared with Group A,the lipid levels in Group B and Group C were significantly lower(P＜0.05).After 3 months and 6 months of treatment,the bodily pain scores in Group C were lower than those in Group B and Group A.There were no statistically significant differences in the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr)and estimated glomerular filtration rate(eGFR)among the 3 groups at all time points(P＞0.05).There was no statistically significant difference in the total incidence of adverse reactions among the 3 groups(P＞0.05),and no serious adverse reactions occurred during treatment in any group.CONCLUSION The lipid-lowering effects of inclisiran and evolocumab combined with statins are comparable in ultra-high-risk ASCVD,and both are superior to statins alone.Inclisiran combined with statins in the treatment of ultra-high-risk ASCVD can significantly improve patients'medication comfort and has also shown a good safety profile,thereby improving medication compliance.关键词
动脉粥样硬化性心血管病/超高危/胆固醇/前蛋白转化酶枯草溶菌素9抑制剂/依洛尤单抗/英克司兰Key words
atherosclerotic cardiovascular disease/ultra-high-risk/cholesterol/proprotein convertase subtilisin/kexin type 9 inhibitor/evolocumab/inclisiran分类
药学
