The reduction in MACEs was observed in White but not in Asian subjects .
Both alirocumab and evolocumab are well tolerated and can greatly improve lipid profiles for patients at high cardiovascular risk .
Both PCSK9 monoclonal antibodies significantly reduce the risk of nonfatal MACEs in patients with previous cardiovascular events , but the effect on all-cause mortality remains uncertain
Proprotein convertase subtilisin/kexin type 9 ( PCSK9 ) monoclonal antibodies are powerful lipid-lowering drugs which have been shown to improve clinical endpoints in patients with hypercholesterolemia .
However , it is not clear how effective PCSK9 monoclonal antibodies are for patients at high cardiovascular risk .
Also , whether the effectiveness of PCSK9 monoclonal antibodies varies between different drug types , dosages , race , and indications for PCSK9 monoclonal antibodies remains unclear .
Therefore , we used recently published studies to systematic ally evaluate the efficacy and safety of PCSK9 monoclonal antibodies by analyzing the lipid profiles , adverse events , and clinical endpoints in patients at high cardiovascular risk .
Prognosis of Patients With Familial Hypercholesterolemia After Acute Coronary Syndromes
BACKGROUND : Patients with heterozygous familial hypercholesterolemia ( FH ) and coronary heart disease have high mortality rates . However , in an era of high-dose statin prescription after acute coronary syndrome ( ACS ) , the risk of recurrent coronary and cardiovascular events associated with FH might be mitigated . We compared coronary event rates between patients with and without FH after ACS . METHODS : We studied 4534 patients with ACS enrolled in a multicenter , prospect i ve cohort study in Switzerl and between 2009 and 2013 who were individually screened for FH on the basis of clinical criteria according to 3 definitions : the American Heart Association definition , the Simon Broome definition , and the Dutch Lipid Clinic definition . We used Cox proportional models to assess the 1-year risk of first recurrent coronary events defined as coronary death or myocardial infa rct ion and adjusted for age , sex , body mass index , smoking , hypertension , diabetes mellitus , existing cardiovascular disease , high-dose statin at discharge , attendance at cardiac rehabilitation , and the GRACE ( Global Registry of Acute Coronary Events ) risk score for severity of ACS . RESULTS : At the 1-year follow-up , 153 patients ( 3.4 % ) had died , including 104 ( 2.3 % ) of fatal myocardial infa rct ion . A further 113 patients ( 2.5 % ) experienced nonfatal myocardial infa rct ion . The prevalence of FH was 2.5 % with the American Heart Association definition , 5.5 % with the Simon Broome definition , and 1.6 % with the Dutch Lipid Clinic definition . Compared with patients without FH , the risk of coronary event recurrence after ACS was similar in patients with FH in unadjusted analyses , although patients with FH were > 10 years younger . However , after multivariable adjustment including age , the risk was greater in patients with FH than without , with an adjusted hazard ratio of 2.46 ( 95 % confidence interval , 1.07–5.65 ; P=0.034 ) for the American Heart Association definition , 2.73 ( 95 % confidence interval , 1.46–5.11 ; P=0.002 ) for the Simon Broome definition , and 3.53 ( 95 % confidence interval , 1.26–9.94 ; P=0.017 ) for the Dutch Lipid Clinic definition . Depending on which clinical definition of FH was used , between 94.5 % and 99.1 % of patients with FH were discharged on statins and between 74.0 % and 82.3 % on high-dose statins  . CONCLUSIONS : Patients with FH and ACS have a > 2-fold adjusted risk of coronary event recurrence within the first year after discharge than patients without FH despite the widespread use of high-intensity statins
The reduction in MACEs was observed in White but not in Asian subjects .
Both alirocumab and evolocumab are well tolerated and can greatly improve lipid profiles for patients at high cardiovascular risk .
Both PCSK9 monoclonal antibodies significantly reduce the risk of nonfatal MACEs in patients with previous cardiovascular events , but the effect on all-cause mortality remains uncertain
Proprotein convertase subtilisin/kexin type 9 ( PCSK9 ) monoclonal antibodies are powerful lipid-lowering drugs which have been shown to improve clinical endpoints in patients with hypercholesterolemia .
However , it is not clear how effective PCSK9 monoclonal antibodies are for patients at high cardiovascular risk .
Also , whether the effectiveness of PCSK9 monoclonal antibodies varies between different drug types , dosages , race , and indications for PCSK9 monoclonal antibodies remains unclear .
Therefore , we used recently published studies to systematic ally evaluate the efficacy and safety of PCSK9 monoclonal antibodies by analyzing the lipid profiles , adverse events , and clinical endpoints in patients at high cardiovascular risk .