Gewählte Publikation:
SHR
Neuro
Krebs
Kardio
Lipid
Stoffw
Microb
Hollstein, T; Vogt, A; Grenkowitz, T; Stojakovic, T; März, W; Laufs, U; Bölükbasi, B; Steinhagen-Thiessen, E; Scharnagl, H; Kassner, U.
Treatment with PCSK9 inhibitors reduces atherogenic VLDL remnants in a real-world study.
Vascul Pharmacol. 2019; 116:8-15
Doi: 10.1016/j.vph.2019.03.002
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
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Scharnagl Hubert
- Co-Autor*innen der Med Uni Graz
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März Winfried
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Stojakovic Tatjana
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- Abstract:
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Proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9-I) reduce low-density lipoprotein (LDL) cholesterol in human studies. Previous studies suggest that PCSK9-I may also affect very-low-density lipoproteins (VLDL). We therefore studied VLDL size and composition in a "real-world" study population with the use of β-quantification.
350 patients (62 ± 11 years old, 58% men, 22% with diabetes mellitus) with different concomitant lipid lowering therapies, and in whom PCSK9-I treatment was indicated, received either evolocumab (140 mg) or alirocumab (75 or 150 mg). The major lipoprotein fractions were separated by β-quantification and lipid and apolipoprotein compositions were determined before and 4 weeks after initiation of PCSK9-I treatment.
After 4 weeks of PCSK9-I treatment, the ratio of triglycerides to apolipoprotein B in VLDL particles (VLDL-TG/apoB ratio) increased by 40% (p < .0001). VLDL-associated apolipoproteins E, CII, and CIII were reduced by 29.4%, 16.4%, and 12.4%, respectively (all p < .0001).
PCSK9-I treatment increased VLDL size (estimated by an increased VLDL-TG/apoB ratio) and reduced VLDL-associated apolipoproteins in a heterogeneous "real-world" study-population, reflecting a higher clearance of small atherogenic VLDL remnant particles by PCSK9-I. This may potentially lower cardiovascular risk in clinical routine patients beyond low-density cholesterol (LDL-C) reduction.
Copyright © 2019 Elsevier Inc. All rights reserved.
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PCSK9 inhibitor
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Evolocumab
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Alirocumab
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Lipoproteins
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VLDL remnants