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Volume 34 Issue 3
May  2022
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Article Contents
Bo-da ZHU, Shuai ZHAO, Peng HAN, Jia-yi WANG, Jia-hao CAO, Zhi-hong WEI, Qing YANG, Xuan YANG, Qin WANG, Wei WANG, Cheng-xiang LI, Kun LIAN. Comparison of clinical effect between evolocumab and alirocumab[J]. Chinese Heart Journal, 2022, 34(3): 293-298. doi: 10.12125/j.chj.202110101
Citation: Bo-da ZHU, Shuai ZHAO, Peng HAN, Jia-yi WANG, Jia-hao CAO, Zhi-hong WEI, Qing YANG, Xuan YANG, Qin WANG, Wei WANG, Cheng-xiang LI, Kun LIAN. Comparison of clinical effect between evolocumab and alirocumab[J]. Chinese Heart Journal, 2022, 34(3): 293-298. doi: 10.12125/j.chj.202110101

Comparison of clinical effect between evolocumab and alirocumab

doi: 10.12125/j.chj.202110101
  • Received Date: 2021-10-30
  • Accepted Date: 2022-02-26
  • Rev Recd Date: 2022-02-23
  • Publish Date: 2022-05-26
  •   AIM  To observe the effects of evolocumab and alirocumab --- two inhibitors of the preprotein converting enzyme, Bacillus subtilis protease Kexin-9 (PCSK9) --- on the efficacy and safety of lipid-lowering therapy in patients with atherosclerotic cardiovascular disease (ASCVD).   METHODS  A total of 148 ASCVD patients who received PCSK9i after percutaneous coronary intervention (PCI) in Xijing Hospital of Air Force Military Medical University from February 2019 to July 2021 were consecutively collected. They were divided into evolocumab group (n=103) and alirocumab group (n=45). The primary treatment regimen was statin based lipid-lowering regimen combined with PCSK9i, and 20 patients received PCSK9i monotherapy. Baseline data during hospitalization (age, sex, BMI, blood pressure, heart rate, alanine aminotransferase, aspartate aminotransferase, creatinine, LVEF, education background, length of stay, past medical history and postoperative medication) were recorded 48h before surgery in the 2 groups. Blood lipid levels were reviewed after 2 months of medication, and the decrease of blood lipid and the occurrence of adverse drug reactions were observed.   RESULTS  Compared with the alirocumab group, patients in the evolocumab group had lower diastolic blood pressure (P<0.05) and aspartate aminotransferase (P<0.01) levels, lower LVEF (P<0.05) levels, and a higher proportion of patients taking aspirin (P<0.05) and ACEI/ARB (P<0.05) after surgery. After treatment, TC and LDL-C levels in 2 groups were significantly decreased, with statistical significance (P<0.01), but HDL-C level in eluzumab group was significantly increased (P<0.05). At the same time, the LDL-C level of the alirocumab group was lower than that of the evolocumab group after treatment (P<0.01). In evolocumab group and alirocumab group, the compliance rate of LDL-C<1.4 mmol/L was 65.3% vs. 84.2% and the standard rate of LDL-C<1.8 mmol/L was 80.0% vs. 94.1%. In terms of postoperative adverse reactions, no adverse reactions occurred in the two groups, and there was no statistical difference in the effects of the two drugs on liver and kidney functions.  CONCLUSION  Both evolocumab and alirocumab have good effect in reducing total cholesterol and low density lipoprotein , and the safety of them are good.Alirocumab is slightly better than evolocumab in lipid lowering rate.

     

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