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Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia

Background: In addition to reducing plasma lipids, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors may produce numerous nonlipid-related pleiotropic effects. The purpose of this trial was to determine the efficacy of PCSK9 inhibitors alone in patients with isolated hypercholesterole...

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Autores principales: Basiak, Marcin, Hachula, Marcin, Kosowski, Michal, Okopien, Boguslaw
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9100169/
https://www.ncbi.nlm.nih.gov/pubmed/35566668
http://dx.doi.org/10.3390/jcm11092542
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author Basiak, Marcin
Hachula, Marcin
Kosowski, Michal
Okopien, Boguslaw
author_facet Basiak, Marcin
Hachula, Marcin
Kosowski, Michal
Okopien, Boguslaw
author_sort Basiak, Marcin
collection PubMed
description Background: In addition to reducing plasma lipids, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors may produce numerous nonlipid-related pleiotropic effects. The purpose of this trial was to determine the efficacy of PCSK9 inhibitors alone in patients with isolated hypercholesterolemia. Methods: The trial enrolled 21 individuals with isolated hypercholesterolemia and atherosclerosis who received alirocumab for 90 days (150 mg every two weeks). Lipids, glucose homeostasis factors, and hemostatic markers were measured in the plasma at baseline and after treatment. Results: The PCSK9 inhibitor administered to these patients reduced plasma levels/activity of fibrinogen (from 3.6 ± 0.5 to 2.9 ± 0.4 g/L, p < 0.01), factor VII (from 143.8 ± 16.7 to 114.5 ± 14.1%, p < 0.01) and plasminogen activator inhibitor-1 (PAI-1) (from 74.9 ± 13.9 to 52.8 ± 9.1 ng/mL, p < 0.001) without a significant reduction in von Willebrand factor levels, and it tended to prolong the partial thromboplastin and prothrombin times. Conclusion: Our findings indicate that treatment with PCSK9 inhibitors has a multipotential effect on fibrinolysis and coagulation in patients with isolated hypercholesterolemia and that this medication may have some future benefits in patients who are statin-intolerant or contraindicated to statin use.
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spelling pubmed-91001692022-05-14 Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia Basiak, Marcin Hachula, Marcin Kosowski, Michal Okopien, Boguslaw J Clin Med Article Background: In addition to reducing plasma lipids, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors may produce numerous nonlipid-related pleiotropic effects. The purpose of this trial was to determine the efficacy of PCSK9 inhibitors alone in patients with isolated hypercholesterolemia. Methods: The trial enrolled 21 individuals with isolated hypercholesterolemia and atherosclerosis who received alirocumab for 90 days (150 mg every two weeks). Lipids, glucose homeostasis factors, and hemostatic markers were measured in the plasma at baseline and after treatment. Results: The PCSK9 inhibitor administered to these patients reduced plasma levels/activity of fibrinogen (from 3.6 ± 0.5 to 2.9 ± 0.4 g/L, p < 0.01), factor VII (from 143.8 ± 16.7 to 114.5 ± 14.1%, p < 0.01) and plasminogen activator inhibitor-1 (PAI-1) (from 74.9 ± 13.9 to 52.8 ± 9.1 ng/mL, p < 0.001) without a significant reduction in von Willebrand factor levels, and it tended to prolong the partial thromboplastin and prothrombin times. Conclusion: Our findings indicate that treatment with PCSK9 inhibitors has a multipotential effect on fibrinolysis and coagulation in patients with isolated hypercholesterolemia and that this medication may have some future benefits in patients who are statin-intolerant or contraindicated to statin use. MDPI 2022-05-01 /pmc/articles/PMC9100169/ /pubmed/35566668 http://dx.doi.org/10.3390/jcm11092542 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Basiak, Marcin
Hachula, Marcin
Kosowski, Michal
Okopien, Boguslaw
Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia
title Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia
title_full Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia
title_fullStr Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia
title_full_unstemmed Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia
title_short Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia
title_sort effect of pcsk9 inhibitors on hemostasis in patients with isolated hypercholesterolemia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9100169/
https://www.ncbi.nlm.nih.gov/pubmed/35566668
http://dx.doi.org/10.3390/jcm11092542
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