Efficacy of single-dose evolocumab injection in early-phase acute myocardial infarction: a retrospective single-center study

Korean J Intern Med. 2024 Sep;39(5):793-800. doi: 10.3904/kjim.2024.080. Epub 2024 Jun 24.

Abstract

Background/aims: Achieving rapid reduction of low-density lipoprotein cholesterol (LDL-C) levels below 55 mg/dL in patients with acute myocardial infarction (AMI) can be challenging with statins alone. This single-center, retrospective study aimed to assess the impact of single-dose injection of evolocumab 140 mg on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in patients with AMI.

Methods: A total of 95 patients with AMI who underwent PCI were divided into the evolocumab (n = 50) and non-evolocumab (n = 45) groups.

Results: The percentage change of LDL-C level at 1-3 weeks from baseline was 78.4 ± 13.4% reduction in the evolocumab group versus 45.6 ± 22.6% in the non-evolocumab group, with a mean difference of -33.5% between the groups (95% CI: -42.6 to -24.5%; p < 0.001). The achievement rate of LDL-C levels below 55 mg/dL at 1-3 weeks was significantly higher in the evolocumab group than in the non-evolocumab group (97.7% vs. 60.0%, p < 0.001).

Conclusion: Patients with AMI who received single-dose injection of evolocumab 140 mg during the peri-PCI period had a significantly greater LDL-C reduction and higher proportion of patients achieved the target LDL-C level in the early phase AMI than those who did not receive evolocumab.

Keywords: Dyslipidemia; Lipids; Myocardial infarction.

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Humanized* / administration & dosage
  • Anticholesteremic Agents* / administration & dosage
  • Anticholesteremic Agents* / adverse effects
  • Biomarkers / blood
  • Cholesterol, LDL* / blood
  • Dyslipidemias / blood
  • Dyslipidemias / diagnosis
  • Dyslipidemias / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction* / blood
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / drug therapy
  • PCSK9 Inhibitors
  • Percutaneous Coronary Intervention*
  • Proprotein Convertase 9
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • evolocumab
  • Cholesterol, LDL
  • Anticholesteremic Agents
  • Biomarkers
  • PCSK9 protein, human
  • PCSK9 Inhibitors
  • Proprotein Convertase 9