Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis

Detalhes bibliográficos
Autor(a) principal: Justino, Gustavo Busch
Data de Publicação: 2023
Tipo de documento: Trabalho de conclusão de curso
Idioma: eng
Título da fonte: Repositório Institucional da UFSC
Texto Completo: https://repositorio.ufsc.br/handle/123456789/253051
Resumo: TCC (graduação) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Medicina.
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spelling Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysisInibidores de PCSK9Lipoproteína (a)PCSK9 inhibitorsAcute coronary syndromeLDL-cholesterolLipoprotein (a)Síndrome coronariana agudaColesterol LDLTCC (graduação) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Medicina.In patients with stable atherosclerotic cardiovascular disease, PCSK9 inhibitors (PCSK9i) have shown a 50-60% reduction in LDL-C from baseline, added to high-intensity statin therapy. However, less is known about the impact of PCSK9i in the setting of an acute coronary syndrome (ACS). Therefore, we performed a systematic review and meta-analysis comparing PCSK9i with placebo in the setting of ACS, added to guideline directed high-intensity or maximally tolerated statin therapy. We included randomized controlled trials (RCTs) with initiation of PCSK9i or placebo within 1 week of presentation or percutaneous coronary intervention for ACS. PubMed, EMBASE, and Cochrane Central were searched. This study followed Cochrane and PRISMA recommendations. Six RCTs were included, totalizing 996 patients of whom 503 (50.5%) received PCSK9i. Mean follow-up ranged from 4 to 52 weeks. LDL-C (MD -44 mg/dL; CI -54.3 to -33.8; p<0.001) and Lp(a) levels (MD -24.0 nmol/L; CI - 43.0 to -4.9; p=0.01) were significantly lower at follow-up with PCSK9i. Similarly, total cholesterol (MD -49.2 mg/dL; CI -59 to -39.3), triglycerides (MD -19 mg/dL; CI -29.9 to -8.2) and Apo B (MD -33.3 mg/dL; CI -44.4 to -22.1) were significantly reduced with PCSK9i. In conclusion, in patients with ACS, early initiation of PCSK9i, added to statin, significantly reduces LDL-C and Lp(a) as compared with placebo. Whether the differences in these atherogenic lipoproteins translate into a reduction in clinical endpoints is yet to b e determined.Florianópolis, SC.Hallal, Ana Luiza CuriUniversidade Federal de Santa Catarina.Justino, Gustavo Busch2023-12-13T13:44:29Z2023-12-13T13:44:29Z2023-11-22info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesis45 f.application/pdfhttps://repositorio.ufsc.br/handle/123456789/253051Open Access.info:eu-repo/semantics/openAccessengreponame:Repositório Institucional da UFSCinstname:Universidade Federal de Santa Catarina (UFSC)instacron:UFSC2023-12-13T13:44:30Zoai:repositorio.ufsc.br:123456789/253051Repositório InstitucionalPUBhttp://150.162.242.35/oai/requestopendoar:23732023-12-13T13:44:30Repositório Institucional da UFSC - Universidade Federal de Santa Catarina (UFSC)false
dc.title.none.fl_str_mv Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis
title Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis
spellingShingle Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis
Justino, Gustavo Busch
Inibidores de PCSK9
Lipoproteína (a)
PCSK9 inhibitors
Acute coronary syndrome
LDL-cholesterol
Lipoprotein (a)
Síndrome coronariana aguda
Colesterol LDL
title_short Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis
title_full Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis
title_fullStr Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis
title_full_unstemmed Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis
title_sort Early initiation of PCSK9 inhibitor therapy versus placebo in patients with acute coronary syndrome: a systematic review and meta-analysis
author Justino, Gustavo Busch
author_facet Justino, Gustavo Busch
author_role author
dc.contributor.none.fl_str_mv Hallal, Ana Luiza Curi
Universidade Federal de Santa Catarina.
dc.contributor.author.fl_str_mv Justino, Gustavo Busch
dc.subject.por.fl_str_mv Inibidores de PCSK9
Lipoproteína (a)
PCSK9 inhibitors
Acute coronary syndrome
LDL-cholesterol
Lipoprotein (a)
Síndrome coronariana aguda
Colesterol LDL
topic Inibidores de PCSK9
Lipoproteína (a)
PCSK9 inhibitors
Acute coronary syndrome
LDL-cholesterol
Lipoprotein (a)
Síndrome coronariana aguda
Colesterol LDL
description TCC (graduação) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Medicina.
publishDate 2023
dc.date.none.fl_str_mv 2023-12-13T13:44:29Z
2023-12-13T13:44:29Z
2023-11-22
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/bachelorThesis
format bachelorThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://repositorio.ufsc.br/handle/123456789/253051
url https://repositorio.ufsc.br/handle/123456789/253051
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv Open Access.
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Open Access.
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 45 f.
application/pdf
dc.publisher.none.fl_str_mv Florianópolis, SC.
publisher.none.fl_str_mv Florianópolis, SC.
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFSC
instname:Universidade Federal de Santa Catarina (UFSC)
instacron:UFSC
instname_str Universidade Federal de Santa Catarina (UFSC)
instacron_str UFSC
institution UFSC
reponame_str Repositório Institucional da UFSC
collection Repositório Institucional da UFSC
repository.name.fl_str_mv Repositório Institucional da UFSC - Universidade Federal de Santa Catarina (UFSC)
repository.mail.fl_str_mv
_version_ 1808651952929636352

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