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Effect of PCSK9 inhibitor on blood lipid levels in patients with high and very-high CVD risk: a systematic review and meta-analysis
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  • Yue Zhang,
  • Yanrong Suo,
  • Lin Yang,
  • Xiaolu Zhang,
  • Qun Yu,
  • Miao Zeng,
  • Wenlan Zhang,
  • Xijuan Jiang,
  • Yijing Wang
Yue Zhang
Tianjin University of Traditional Chinese Medicine Institute of Chinese Medicine
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Yanrong Suo
Traditional Chinese medicine department Ganzhou people’s hospital Ganzhou China
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Lin Yang
Tianjin University of Traditional Chinese Medicine Institute of Chinese Medicine
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Xiaolu Zhang
Tianjin University of Traditional Chinese Medicine Institute of Chinese Medicine
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Qun Yu
Tianjin University of Traditional Chinese Medicine Institute of Chinese Medicine
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Miao Zeng
Tianjin University of Traditional Chinese Medicine Institute of Chinese Medicine
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Wenlan Zhang
Tianjin University of Traditional Chinese Medicine Institute of Chinese Medicine
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Xijuan Jiang
Tianjin University of Traditional Chinese Medicine Institute of Chinese Medicine

Corresponding Author:[email protected]

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Yijing Wang
Tianjin University of Traditional Chinese Medicine
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Abstract

Objectives We aimed to investigate the effects of PCSK9 inhibitor on blood lipid levels in patients with high and very-high cardiovascular risk. Design 14 trials (n=52,586 patients) comparing treatment with or without PCSK9 inhibitors were retrieved from PubMed and Embase updated to 1st Jun 2021. The data quality of included studies was assessed by two independent researchers using the Cochrane systematic review method. All-cause mortality, cardiovascular mortality and changes in serum LDL-C, TC, TG, ApoB, LP (a), Non HDL-C, HDL-C and ApoA1 from baseline were analyzed using Rev Man 5.1.0 software. Results Compared to treatments without PCSK9 inhibitor, addition of PCSK9 inhibitors (evolocumab and alirocumab) had obvious decreasing effects on the levels of LDL-C [MD=-46.86, 95% CI (-54.99 to -38.72), P<0.00001], TC [MD=-31.92, 95% CI (-39.47 to -24.38), P<0.00001], TG [MD=-8.13, 95% CI (-10.48 to -5.79), P<0.00001], LP(a) [MD=-26.69, 95% CI (-27.93 to -25.44), P<0.00001], Non HDL-C [MD=-42.86, 95% CI (-45.81 to -39.92), P<0.00001] and ApoB [MD=-38.44, 95% CI (-42.23 to -34.65), P<0.00001] in high CVD risk patients. Conversely, changes of HDL-C [MD = 6.27, CI (5.17 to 7.36), P < 0.00001] and ApoA1 [MD = 4.33, 95% CI (3.53 to 5.13), P < 0.00001] from baseline were significantly more in high CVD risk patients who received PCSK9 inhibitors treatment. Conclusion Addition of PCSK9 inhibitors to standard therapy resulted in definite improvement in blood lipid levels than those therapies without its addition.