AIM To observe the lipid-lowering efficacy and prognostic effect of Alirocumab, a preprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, combined with conventional treatment in patients with acute coronary syndrome (ACS).

METHODS  110 ACS patients admitted to Beijing Anzhen Hospital from September 2021 to September 2022 after PCI were selected. All patients were enrolled and treated with Alirocumab on the basis of routine treatment. The medication status, blood lipid levels, cardiovascular adverse events, and drug adverse reactions of patients in the real world were followed up after discharge. According to whether the patients stopped Alirocumab after discharge, they were divided into treatment group and discontinuation group.

RESULTS  There was no statistically significant difference in multiple indicators such as age, blood sugar, liver and kidney function between the two groups of patients. At one year of follow-up, the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) in the treatment group were significantly lower than those in the discontinuation group, with a statistically significant difference (all P<0.01); There was no significant difference in the levels of high-density lipoprotein cholesterol (HDL-C), the incidence of clinical adverse events, and drug adverse reactions.

CONCLUSION  The use of conventional lipid-lowering drugs and the addition of Alirocumab in ACS patients is able to control blood lipids to ideal levels in the short term, reduce the incidence of major adverse cardiovascular events, and have favorable safety and tolerability. At the same time, it is not recommended to discontinue Alirocumab in patients with lower LDL-C levels.