Abstract
Objective To explore clinical curative effect and safety of evolocumab injection combined with atorvastatin calcium tablets in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods According to different lipid-lowering regimens,patients with ACS were divided into control group and treatment group.Within 24 h after PCI,control group was treated with atorvastatin calcium tablets every night before sleep(20 mg once,once a day),while treatment group was given subcutaneous injection of evolocumab(140 mg/once,once every two weeks)on basis of control group.All patients were treated continuously for 6 months.The blood lipid profile including total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)],apolipoprotein B(ApoB),vascular ultrasound indexes[carotid plaque area,carotid intima-media thickness(IMT)],cardiac function[left ventricular end-diastolic/systolic diameter(LVEDD,LVESD),ratio of early mitral inflow velocity to early diastolic mitral annular velocity(E/e'),left ventricular ejection fraction(LVEF)]and vascular endothelial function and inflammatory markers[endothelin-1(ET-1),nitric oxide(NO),von Willebrand factor(vWF),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)]were compared between the two group,and the safety was evaluated.All patients were followed up till 12 months after surgery to compare the incidence of major adverse cardiovascular events(MACE)between the two groups.Results Among the 107 patients in this study,there were 53 cases in control group and 54 cases in treatment group.After treatment,response rate of treatment group and control group were 94.44％(51 cases/54 cases)and 79.25％(42 cases/53 cases),respectively(P＜0.05).After 6 months of treatment,levels of serum TC in treatment group and control group were(3.11±0.46)and(3.66±0.52)mmol·L-1,respectively;TG levels were(1.40±0.28)and(1.69±0.30)mmol·L-1,respectively;LDL-C levels were(1.39±0.31)and(2.05±0.44)mmol·L-1,respectively;HDL-C levels were(1.09±0.21)and(1.04±0.25)mmol·L-1,respectively;Lp(a)levels were(196.74±63.69)and(256.61±57.71)mg·L-1,respectively;carotid IMT was(0.94±0.11)and(1.01±0.18)mm,respectively;plaque areas were(1.36±0.24)and(1.54±0.33)cm,respectively;LVEF were(58.86±4.10)％and(55.44±3.75)％,respectively;E/e'were 11.20±1.06 and 12.43±1.15,respectively;vWF levels were(121.29±18.85)％and(138.18±19.96)％,respectively;NO levels were(65.71±10.31)and(57.39±9.06)μmol·L-1,respectively;hs-CRP levels were(3.09±0.86)and(5.44±1.09)mg·L-1,respectively;IL-6 levels were(8.45±1.21)and(11.19±1.83)ng·L-1,respectively;there were statistically significant differences in the above indexes between the two groups(all P＜0.05).During the 12 months of follow-up,incidence of major adverse cardiovascular events(MACE)in treatment group and control group were 7.41％(4 cases/54 cases)and 24.53％(13 cases/53 cases),respectively,with statistically significant difference(P＜0.05).During treatment,total incidence of adverse drug reactions between treatment group and control group were 12.96％(7 cases/54 cases)and 9.43％(5 cses/53 cases),respectively,without statistically significant difference(P＞0.05).Conclusion Evolocumab injection combined with atorvastatin tablet can effectively lower blood lipid,inhibit the progression of atherosclerosis,enhance cardiac function,improve endothelial function,alleviate inflammation and reduce the risk of MACE in patients with ACS after PCI,which has good safety.关键词
依洛尤单抗注射液/阿托伐他汀钙片/急性冠状动脉综合征/经皮冠状动脉介入治疗/血脂谱Key words
evolocumab injection/atorvastatin calcium tablet/acute coronary syndrome/percutaneous coronary intervention/blood lipid profile分类
医药卫生
