Control of cardiovascular risk factors and health behaviors in patients post acute coronary syndromes eligible for protein convertase subtilisin/kexin-9 inhibitors.

Abstract

BACKGROUND:

We aimed to examine cardiovascular risk factors and health behaviors in patients with acute coronary syndromes (ACS) according to potential extension of eligibility criteria for protein convertase subtilisin/kexin-9 inhibitors (PCSK9i) to all patients with low-density lipoprotein cholesterol (LDL-c) equal or above 1.8 mmol/l.

METHODS:

In this prospective cross-sectional study, patients with ACS between 2009 and 2016 and with available LDL-c at one year were considered. We defined three mutually exclusive groups of patients according to eligibility for PCSK9i: "not eligible", "currently eligible", and "newly eligible". We explored the control of cardiovascular risk factors and health behaviors.

RESULTS:

Out of 3025 patients who had an ACS one year ago, 1071 (35.4%) were not eligible for PCSK9i, 415 (13.7%) were currently eligible, and 1539 (50.9%) were newly eligible. The proportion of patients with uncontrolled hypertension in the not eligible group was lower than in the group currently eligible (27.6% vs 33.6%, p = 0.02), but similar to the group newly eligible (27.6% vs 28.2%, p = 0.73). The proportion of smokers in the not eligible group was lower than in the group currently eligible (21.2% vs 28.0%, p = 0.02), but similar to the group newly eligible (21.2% vs 22.5%, p = 0.51).

CONCLUSIONS:

More than half of patients with ACS would be additionally eligible for PCSK9i if prescription is extended from current guidelines to all patients with LDL-c equal or above 1.8 mmol/l. Patients currently eligible for PCSK9i one year after an ACS had a worst control of cardiovascular risk factors than patients potentially newly eligible.

• Authors: Audrey Butty, Baris Gencer, Konstantinos C Koskinas, David Carballo, Lorenz Räber, Roland Klingenberg, Christian M Matter, Thomas F Lüscher, Stephan Windecker, Olivier Muller, Nicolas Rodondi, François Mach, David Nanchen
• Journal: International journal of cardiology (Int J Cardiol) Vol. 299 Pg. 289-295 (01 15 2020) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 31668506 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2019 Elsevier B.V. All rights reserved.

Chemical References

• Cardiovascular Agents
• Enzyme Inhibitors
• PCSK9 Inhibitors
• PCSK9 protein, human
• Proprotein Convertase 9

Topics

• Acute Coronary Syndrome (drug therapy, enzymology)
• Aged
• Cardiovascular Agents (administration & dosage)
• Cardiovascular Diseases (drug therapy, enzymology)
• Cross-Sectional Studies
• Enzyme Inhibitors (administration & dosage)
• Female
• Health Behavior (drug effects, physiology)
• Humans
• Male
• Middle Aged
• PCSK9 Inhibitors
• Proprotein Convertase 9 (metabolism)
• Prospective Studies
• Risk Factors