Effects of alirocumab combined with atorvastatin on clinical efficacy and safety in patients with acute coronary syndrome after PCI

HAO Cuijun; WANG Rui; MA Yiping; ZHANG Xueping; LIU Yanan; QIN Shaoqiang

doi:10.6039/j.issn.1001-0408.2025.10.11

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Effects of alirocumab combined with atorvastatin on clinical efficacy and safety in patients with acute coronary syndrome after PCI

更新时间：2025-09-23

- Effects of alirocumab combined with atorvastatin on clinical efficacy and safety in patients with acute coronary syndrome after PCI
- ZHONGGUO YAOFANG Vol. 36, Issue 10, Pages: 1216-1220(2025)
- 作者机构：
  
  河北北方学院附属第一医院心血管内科，河北张家口　075000
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.10.11
  CLC： R969.4;R972
- Received：13 November 2024，
  
  Revised：2025-04-16，
  
  Accepted：16 April 2025，
  
  Published：30 May 2025
- 稿件说明：
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郝翠君,王蕊,马逸平,等.阿利西尤单抗联合阿托伐他汀对急性冠脉综合征患者PCI术后临床疗效和安全性的影响 [J].中国药房,2025,36(10):1216-1220.

HAO Cuijun,WANG Rui,MA Yiping,et al.Effects of alirocumab combined with atorvastatin on clinical efficacy and safety in patients with acute coronary syndrome after PCI[J].ZHONGGUO YAOFANG,2025,36(10):1216-1220.
郝翠君,王蕊,马逸平,等.阿利西尤单抗联合阿托伐他汀对急性冠脉综合征患者PCI术后临床疗效和安全性的影响 [J].中国药房,2025,36(10):1216-1220. DOI： 10.6039/j.issn.1001-0408.2025.10.11.

HAO Cuijun,WANG Rui,MA Yiping,et al.Effects of alirocumab combined with atorvastatin on clinical efficacy and safety in patients with acute coronary syndrome after PCI[J].ZHONGGUO YAOFANG,2025,36(10):1216-1220. DOI： 10.6039/j.issn.1001-0408.2025.10.11.

摘要

目的

探讨阿利西尤单抗联合阿托伐他汀对急性冠脉综合征（ACS）患者接受经皮冠脉介入术（PCI）后临床疗效和安全性的影响。

方法

将2021年1月至2023年12月我院收治的207例患有ACS并接受PCI治疗者，按随机数字表法分为阿利西尤单抗组、依折麦布组和对照组，每组69例。所有患者均在PCI术后接受常规预防血栓、降压等治疗。在此基础上，对照组患者采用阿托伐他汀（20 mg/次，每天1次）治疗；依折麦布组患者采用依折麦布（10 mg/次，每天1次）+阿托伐他汀（20 mg/次，每天1次）治疗；阿利西尤单抗组患者采用阿利西尤单抗（75 mg/次，每2周1次）+阿托伐他汀（20 mg/次，每天1次）治疗。3组患者均治疗8周，治疗后再随访6个月。比较3组患者治疗前后的心功能指标、脂代谢指标水平以及随访期间的主要心血管不良事件（MACE）及其他药物不良反应（ADR）的发生情况。

结果

治疗8周后，3组患者的心功能和脂代谢指标水平均较同组治疗前显著改善（

＜0.05）；与对照组和依折麦布组相比，阿利西尤单抗组患者的左室射血分数显著升高，左室舒张末期内径（LVEDD）显著缩短（

＜0.05）；与对照组相比，依折麦布组患者的LVEDD显著缩短（

＜0.05），阿利西尤单抗组和依折麦布组患者的总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平均显著降低（

＜0.

05）。随访期间，3组患者的MACE总发生率和头痛、腹痛等其他ADR总发生率比较，差异均无统计学意义（

＞0.05）。

结论

阿利西尤单抗联合阿托伐他汀可显著改善PCI术后ACS患者的心功能，调节其脂代谢指标水平，且不会增加MACE或其他ADR的发生风险。

Abstract

OBJECTIVE

To investigate the effects of alirocumab combined with atorvastatin on clinical efficacy and safety of patients with acute coronary syndrome （ACS） who underwent percutaneous coronary intervention （PCI）.

METHODS

A total of 207 patients with ACS who underwent PCI in our hospital from January 2021 to December 2023 were randomly divided into alirocumab group， ezetimibe group and control group， with 69 cases in each group. All patients received routine thrombosis prevention and antihypertensive treatment after PCI. On this basis， patients in the control group were treated with atorvastatin （20 mg/time， once a day）； patients in the ezetimibe group were treated with ezetimibe （10 mg/time， once a day） + atorvastatin （20 mg/time， once a day）； patients in the alirocumab group were treated with alirocumab （75 mg/time， once every 2 weeks） + atorvastatin （20 mg/time， once a day）. All patients in the three groups were treated for 8 weeks and followed up for another 6 months after treatment. The levels of cardiac function and lipid metabolism indices before and after treatment， as well as the occurrence of major adverse cardiovascular event （MACE） and other adverse drug reaction （ADR） during the follow-up period were compared among the three groups.

RESULTS

After treatment for 8 weeks， the levels of cardiac function and lipid metabolism indices in the three groups were significantly improved compared with those before treatment （

＜0.05）. Compared with the control group and ezetimibe group， the left ventricular ejection fraction in the alirocumab group was significantly increased， and the left ventricular end-diastolic diameter （LVEDD） was significantly shortened （

＜0.05）. Compared with control group， LVEDD of ezetimibe group was significantly shortened （

＜0.05）， the levels of total cholesterol， triglyceride and low-density lipoprotein cholesterol in the alirocumab group and ezetimibe group were significantly decreased （

＜0.05）. During the follow-up period， there was no significant difference in the total incidence of MACE and the total incidence of other ADR such as headache and abdominal pain among the three groups （

＞0.05）.

CONCLUSIONS

Alirocumab combined with atorvastatin can significantly improve cardiac function and regulate lipid metabolism indices in patients with ACS after PCI without increasing the risk of MACE or other ADR.

关键词

Keywords

references

BYRNE R A ， ROSSELLO X ， COUGHLAN J J ， et al . 2023 ESC guidelines for the management of acute coronary syndromes：developed by the task force on the ma-nagement of acute coronary syndromes of the European Society of Cardiology （ESC） [J ] . Eur Heart J Acute Cardiovasc Care ， 2024 ， 13 （ 1 ）： 55 - 161 .

KONDO S ， MIZUKAMI T ， KOBAYASHI N ， et al . Diag-nosis and prognostic value of the underlying cause of acute coronary syndrome in optical coherence tomography-guided emergency percutaneous coronary intervention [J ] . J Am Heart Assoc ， 2023 ， 12 （ 20 ）： e030412 .

BYTYÇI I ， MORINA D ， BYTYQI S ， et al . Percutaneous coronary intervention is not superior to optimal medical therapy in chronic coronary syndrome：a meta-analysis [J ] . J Clin Med ， 2023 ， 12 （ 4 ）： 1395 .

BELLOSTA S ， CORSINI A . Drug interactions in cardi-ology：focus on statins and their combination with other lipid-lowering drugs [J ] . Expert Opin Drug Metab Toxicol ， 2024 ， 20 （ 11/12 ）： 1013 - 1021 .

JANG J Y ， KIM S ， CHO J ， et al . Comparative effectiveness of moderate-intensity statin with ezetimibe therapy versus high-intensity statin monotherapy in patients with acute coronary syndrome：a nationwide cohort study [J ] . Sci Rep ， 2024 ， 14 （ 1 ）： 838 .

SZAREK M ， REIJNDERS E ， STEG P G ， et al . Comparison of change in lipoprotein（a） mass and molar concentrations by alirocumab and risk of subsequent cardiovascular events in ODYSSEY OUTCOMES [J ] . Eur J Prev Cardiol ， 2024 ， 31 （ 10 ）： e75 - e78 .

NGUYEN H ， HUBERT B ， ROGEN C ， et al . Effect of alirocumab monotherapy vs. ezetimibe plus statin therapy on LDL-C lowering in veterans with history of ASCVD [J ] . Fed Pract ， 2024 ， 41 （ 11 ）： 376 - 381 .

ZIOGOS E ， CHELKO S P ， HARB T ， et al . Platelet activation and endothelial dysfunction biomarkers in acute coronary syndrome：the impact of PCSK9 inhibition [J ] . Eur Heart J Cardiovasc Pharmacother ， 2023 ， 9 （ 7 ）： 636 - 646 .

中国医师协会急诊医师分会，国家卫生健康委能力建设与继续教育中心急诊学专家委员会，中国医疗保健国际交流促进会急诊急救分会 . 急性冠脉综合征急诊快速诊治指南：2019 [J ] . 临床急诊杂志， 2019 ， 20 （ 4 ）： 253 - 262 .

OZAKI Y ， TOBE A ， ONUMA Y ， et al . CVIT expert consensus document on primary percutaneous coronary intervention （PCI） for acute coronary syndromes （ACS） in 2024 [J ] . Cardiovasc Interv Ther ， 2024 ， 39 （ 4 ）： 335 - 375 .

黄刚，徐俊波，朱煜欣 . 高血压患者合并颈动脉斑块是否应该接受他汀类药物和/或抗血小板治疗？ [J ] . 中华高血压杂志， 2023 ， 31 （ 8 ）： 705 - 708 .

DAMARPALLY N ， SINHA T ， MARICELA NUNEZ M ， et al . Comparison of effectiveness of high dose statin monotherapy with combination of statin and ezetimibe to prevent cardiovascular events in patients with acute coronary syndrome：a systematic review and meta-analysis [J ] . Cureus ， 2024 ， 16 （ 3 ）： e55922 .

JUN J E ， JEONG I K ， AHN K J ， et al . Combination of low- or moderate-intensity statin and ezetimibe vs. high-intensity statin monotherapy on primary prevention of cardiovascular disease and all-cause death：a propensity-matched nationwide cohort study [J ] . Eur J Prev Cardiol ， 2024 ， 31 （ 10 ）： 1205 - 1213 .

ZHANG Y H ， ZHANG A J ， WU Y ， et al . Early addition of evolocumab to statin treatment in patients with acute coronary syndrome and multivessel disease undergoing percutaneous coronary intervention [J ] . Rev Cardiovasc Med ， 2023 ， 24 （ 9 ）： 270 .

RÄBER L ， UEKI Y ， OTSUKA T ， et al . Effect of alirocumab added to high-intensity statin therapy on coronary atherosclerosis in patients with acute myocardial infarction：the PACMAN-AMI randomized clinical trial [J ] . JAMA ， 2022 ， 327 （ 18 ）： 1771 - 1781 .

OUYANG Z R ， MA M Y ， ZHANG Z W ， et al . Targeted degradation of PCSK9 in vivo by autophagy-tethering compounds [J ] . J Med Chem ， 2024 ， 67 （ 1 ）： 433 - 449 .

GUEDENEY P ， GIUSTINO G ， SORRENTINO S ， et al . Efficacy and safety of alirocumab and evolocumab：a syste-matic review and meta-analysis of randomized controlled trials [J ] . Eur Heart J ， 2022 ， 43 （ 7 ）： e17 - e25 .

KOSKINAS K C ， HÄNER J ， UEKI Y ， et al . Association of lipoprotein（a） with changes in coronary atherosclerosis in patients treated with alirocumab [J ] . Circ Cardiovasc Imaging ， 2024 ， 17 （ 11 ）： e016683 .

SCHWARTZ G G ， SZAREK M ， BHATT D L ， et al . Transiently achieved very low LDL-cholesterol levels by statin and alirocumab after acute coronary syndrome are asso-ciated with cardiovascular risk reduction：the ODYSSEY OUTCOMES trial [J ] . Eur Heart J ， 2023 ， 44 （ 16 ）： 1408 - 1417 .

AGNELLO F ， MAURO M S ， ROCHIRA C ， et al . PCSK9 inhibitors：current status and emerging frontiers in lipid control [J ] . Expert Rev Cardiovasc Ther ， 2024 ， 22 （ 1/2/3 ）： 41 - 58 .

TRUDSØ L C ， GHOUSE J ， AHLBERG G ， et al . Association of PCSK9 loss-of-function variants with risk of heart failure [J ] . JAMA Cardiol ， 2023 ， 8 （ 2 ）： 159 - 166 .

QUAGLIARIELLO V ， BISCEGLIA I ， BERRETTA M ， et al . PCSK9 inhibitors in cancer patients treated with immune-checkpoint inhibitors to reduce cardiovascular events：new frontiers in cardioncology [J ] . Cancers（Basel）， 2023 ， 15 （ 5 ）： 1397 .

DUTKA M ， ZIMMER K ， ĆWIERTNIA M ， et al . The role of PCSK9 in heart failure and other cardiovascular di-seases：mechanisms of action beyond its effect on LDL cholesterol [J ] . Heart Fail Rev ， 2024 ， 29 （ 5 ）： 917 - 937 .

SCHONCK W A M ， STROES E S G ， HOVINGH G K ， et al . Long-term efficacy and tolerability of PCSK9 targeted therapy：a review of the literature [J ] . Drugs ， 2024 ， 84 （ 2 ）： 165 - 178 .

SEIJAS-AMIGO J ， CORDERO A ， OLMO R F ， et al . Patients with high cardiovascular risk as candidates to bempedoic acid，after treatment with statins，ezetimibe and PCSK9 inhibitors：an estimation and cost-effectiveness analysis [J ] . J Cardiovasc Pharmacol ， 2023 ， 81 （ 1 ）： 70 - 75 .

胡群亮，田竺，张盛蕊，等 . PCSK9抑制剂联合阿托伐他汀对颅内动脉粥样硬化性狭窄的治疗效果 [J ] . 中风与神经疾病杂志， 2024 ， 41 （ 4 ）： 349 - 354 .

SHI W H ， XU Y ， ZHOU L ， et al . In-hospital initiation of a PCSK9 inhibitor in patients with acute coronary syndrome：a systematic review and meta-analysis of rando-mized controlled trials [J ] . Medicine （Baltimore）， 2024 ， 103 （ 10 ）： e37416 .

JI J R ， WEI X Y ， CHEN W S ， et al . Effects of early PCSK9 inhibitor application on inflammation levels and microcirculatory function after PCI in patients with NSTE-ACS [J ] . Am J Transl Res ， 2023 ， 15 （ 5 ）： 3586 - 3596 .

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