Coronary heart disease and chronic kidney disease: the possibilities of PCSK9 inhibitors in the achievement of atherogenic lipoproteins target values
https://doi.org/10.35401/2541-9897-2022-25-2-14-21
Abstract
Objective: Possibilities evaluation of achieving the target values of atherogenic lipoproteins in patients with coronary heart disease (CHD) in combination with renal dysfunction during drug correction with PCSK9 inhibitors.
Material and methods: The study included 76 men with CHD with very high cardiovascular risk divided into 2 groups: without chronic kidney disease (CKD) (n = 39) and with stage IIIA–IIIB CKD (n = 37). All patients did not reach the target values of lowdensity lipoprotein cholesterol (LDL cholesterol) after 8 weeks of the maximum dose of atorvastatin and ezetimibe, which was the motivation for the use of PCSK9‑alirocumab inhibitors, with control of the lipid profile and glomerular filtration rate for 6 months.
Results: In the group of patients with CHD, 87.1% of patients (n = 34) reached the target values of LDL cholesterol, the level of LDL cholesterol decreased from 4.41 ± 0.19 mmol to 1.28 ± 0.14 mmol (p < 0.001), in the group of patients with CHD + CKD stage IIIA–IIIB 56.7% of patients reached the target values (n = 21), the LDL cholesterol level decreased from 4.6 ± 0.2 mmol to 1.37 ± 0.09 mmol (p < 0.001). There was no statistically significant change in the glomerular filtration rate during the study.
Conclusion: The results of this study demonstrate the obvious effectiveness of PCSK9 inhibitors in achieving LDL cholesterol target values in patients with coronary heart disease with a very high cardiovascular risk. During the study, a decrease in the level of LDL cholesterol by more than 70% was noted. The absence of CKD in CHD patients increases the chance of achieving LDL cholesterol target values by 81% (OR 0.19).
About the Authors
G. S. Mal
Kursk State Medical University
Russian Federation
Russian Federation
Galina S. Mal, Dr. Sci. (Med.), Professor, Head of the Pharmacology Department
Kursk
A. A. Kuznetsov
Moscow Regional Hospital named after Prof. Rozanov V.N.
Russian Federation
Russian Federation
Andrey A. Kuznetsov, a person assigned to prepare a dissertation at the Department of Pharmacology, Kursk State Medical University; Cardiologist, Cardiology Department
Aviatsionnaya str., 35, Pushkino, 141206
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For citations:
Mal G.S., Kuznetsov A.A. Coronary heart disease and chronic kidney disease: the possibilities of PCSK9 inhibitors in the achievement of atherogenic lipoproteins target values. Innovative Medicine of Kuban. 2022;(2):14-21. (In Russ.) https://doi.org/10.35401/2541-9897-2022-25-2-14-21
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