| Acute myocardial infarction(AMI)is an extremely dangerous disease that can cause death in a very short period of time.With the development of percutaneous coronary intervention(PCI),the treatment of AMI patients has been greatly improved.However,the morbidity and mortality of AMI are still increasing in recent years.Numerous studies have confirmed that the increase of low-density lipoprotein cholesterol(LDL-C)concentration plays an important role in the progression of atherosclerotic cardiovascular disease(ASCVD).So it is extremely important to reduce the level of LDL-C in patients with AMI.At present,the traditional lipid-lowering drugs are statins drugs.However,statins drugs are difficult to make LDL-C reach the target value,so the lipid-lowering program needs to be adjusted urgently.Objective:To explore the effects of PCSK9 inhibitors on blood lipids and inflammatory cytokines,major adverse cardiovascular events(MACE)and adverse drug reactions in patients with AMI after PCI.Methods:A total of 80 AMI patients who underwent PCI in Handan Central Hospital from October 2020 to June 2022 were selected.The patients were divided into control group and observation group by random number table method,with 40 patients in each group.Patients in the control group were treated with oral rosuvastatin calcium tablets 10 mg qn,while patients in the observation group were treated with oral rosuvastatin calcium tablets 10 mg qn combined with subcutaneous injection of eloizumab 140 mg q2 w.Both groups were treated continuously for 1 year.The basic information of the two groups of patients was collected before treatment.Blood lipid indexes such as triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),LDL-C,lipoprotein a [Lp(a)] and inflammatory indexes such as high-sensitivity Creactive protein(hs-CRP)and interleukin 6(IL-6),liver function,renal function,blood sugar,etc were monitored before treatment and at 4,12 and 24 weeks of treatment.Within 1 year of medication,patients were followed up for MACE events and adverse drug reactions.This study used SPSS 26.0 statistical software.If P < 0.05,the difference was considered statistically significant.Results:A total of 80 patients with AMI who underwent PCI in Handan Central Hospital from October 2020 to June 2022 were included in this study.The patients were divided into control group(rosuvastatin group)and observation group(rosuvastatin + PCSK9 inhibitor group)by random number table method.Except for 5 cases that fell off during follow-up,37 cases in the control group and 38 cases in the observation group were finally included.1 There was no obvious discrepancy in age,sex,weight index,previous history of hypertension,diabetes mellitus history,history of cerebral vascular diseases,history of cigarette smoking,drinking history,AMI type and other general conditions between the two groups before treatment(P>0.05).2 There was no significant difference in blood glucose(GLU),creatinine(Cr),alanine aminotransferase(ALT),aspartate aminotransferase(AST),uric acid(UA),white blood cell count(WBC),neutrophil count(N),hemoglobin(HGB),platelet count(PLT)between the two groups before treatment(P>0.05).3 There was no statistic significance in the levels of TG,TC,HDL-C,LDLC,Apo A1,Apo B,LP(a),hs-CRP and IL-6 between the two groups before treatment(P>0.05).4 After 4 weeks,12 weeks and 24 weeks of treatment,the levels of TG,TC,LDL-C and LP(a)in the two groups were lower than pre-treatment data,which was statistically significant.the difference between the two groups was statistically significant(P<0.05).The level of HDL-C was higher than that before treatment,which was statistically significant(P<0.05).Compared with4 weeks of treatment,the levels of TG,TC,HDL-C,HDL-C,LDL-C and LP(a)in 2 groups at 12 weeks of treatment were statistically significant(P<0.05).The changes of TG,HDL-C,LDL-C and LP(a)in the two groups at week 24 were statistically significant compared with those at week 12(P<0.05),but the decrease of TC was not statistically significant compared with that at week 12(P>0.05).There was no significant difference in TG and HDL-C levels between the two groups at the 4th,12 th and 24 th weeks of treatment(P>0.05).The levels of TC,LDL-C and LP(a)in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).After 24 weeks of treatment,the rate of reaching the standard of LDL-C in the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).5 The hs-CRP and IL-6 levels in 2 groups were decreased compared with pre-treatment after 4,12 and 24 weeks of treatment,with statistical significance(P<0.05).The levels of hs-CRP and IL-6 in the two groups at 12 weeks of treatment were lower than those at 4 weeks,with statistical significance(P<0.05).The levels of hs-CRP and IL-6 in the two groups at 24 weeks of treatment were lower than those at 12 weeks,with statistical significance(P<0.05).There was no statistically significant difference in hs-CRP levels between the two groups at 4 and 12 weeks of treatment(P>0.05);while IL-6levels were significantly lower in the observation group compared to the control group,and the data in both groups were statistically significant(P<0.05).At 24 weeks of treatment,hs-CRP and IL-6 levels were lower in the observation group compared to the control group,and the difference between the two groups was statistically significant(P<0.05).6 During the 1-year follow-up,the observation group had a lower incidence of major cardiovascular adverse events than the control group,but the difference between the two groups was not statistically significant after statistical analysis(P>0.05).7 During the 1-year follow-up,there was no statistic significance in incidence rates of drug side effects of between the two groups(P>0.05).Conclusions:1 This study showed that the combined PCSK9 inhibitor group could significantly reduce the levels of TC,LDL-C and Lp(a),and significantly improve the LDL-C compliance rate compared with the statin group.2 This study showed that the combined PCSK9 inhibitor group could reduce the levels of hs-CRP and IL6 compared with the statin alone group.3 This study showed that the combined PCSK9 inhibitor group could slightly lower rate of major cardiovascular adverse events compared with the statin alone group.4 This study showed no significant difference in adverse drug reactions in combination with PCSK9 inhibitors compared with statins alone. |
