演題

Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK-9) Inhibitors Improve Lipid Profile and Vascular Atherosclerotic Plaque Formation in High-risk Familial Hypercholesterolemia.

[演者] Takuro Abe:1
[共同演者] Haruki Sekiguchi:1, Jihaeng Im:1, Akiko Sakai:1, Kayoko Sato:1, Nobuhisa Hagiwara:1
1:Department of Cardiology, Tokyo Women's Medical University, Tokyo

Introduction:The effectiveness of proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors in patients with ischemic heart disease was revealed by the GLAGOV and FOURIER trials. For secondary prevention, low-density lipoprotein cholesterol(LDL-C) levels should be controlled below 70mg/dL. However, for the patients with familial hypercholesterolemia(FH), it is difficult to reach the target levels of LDL-C with conventional hypolipidemic drugs. We examined the clinical effects of PCSK-9 inhibitors treated with high-risk FH patients in our hospital.Methods:From May 2016, we administered PCSK-9 inhibitors to the patients with heterozygous FH(hFH). We analyzed the clinical course for first and second prevention, clinical characteristics, biochemical data, physiological examination, and gene mutation in the consecutive 16 high-risk hFH patients(8 male and 8 female) for 24W. Result:The age of hFH patients was 59.4±13.2 years and BMI was 26.9±4.1 kg/m². We found 6 of LDLR and 3 of PCSK-9 gene mutations in hFH patients, and 30% of those had double heterozygous mutations. The T-cho, LDL-C, ApoB, LP(a), and oxidized LDL-C were improved significantly after PCSK-9 inhibitor treatments for 4W. In many cases, the maximum carotid artery intima-media thickness(IMT) and achilles tendon xanthoma(ATX), and coronary artery plaques were decreased dramatically after 24W.Conclusion:The atherosclerotic plaque formation in high-risk FH patients was improved following strong lipids-lowering effects by PCSK-9 inhibitor, it could be prevented the future cardiovascular events.

[Keywords] cholesterol-lowering drugs / atherosclerosis

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