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Low Density Lipoprotein (LDL) Cholesterol as a Causal Role for Atherosclerotic Disease: Potential Role of PCSK9 Inhibitors

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Abstract

Proprotein convertase subtilisin/kexin type 9 (PCSK9)-related discoveries of the turn of the century have translated into substantial novelty in dyslipidemia treatment in the last 5 years. With chronic preventable atherosclerotic cardiovascular diseases (ASCVD) representing an epidemic of morbidity and mortality worldwide, low-density lipoprotein cholesterol (LDL-c) reduction represents a public health priority. By overcoming two major statin-related issues, namely intolerance and ineffectiveness, PCSK9 inhibitors have offered a safe and effective option in selected clinical settings where LDL-c reduction is required. Herein, we recapitulate recent findings, clinical applications, and ASCVD prevention potential of PCSK9 inhibition, with focus on anti-PCSK9 monoclonal antibodies, evolocumab and alirocumab.

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Notes

  1. Consistent with guidelines, documented clinical ASCVD includes previous acute myocardial infarction, acute coronary syndrome (ACS), coronary revascularization and other arterial revascularization procedures, stroke and transient ischaemic attack, aortic aneurysm, and peripheral arterial disease. Unequivocally documented ASCVD on imaging includes plaque on coronary angiography or carotid ultrasound. It does not include some increase in continuous imaging parameters such as intima–media thickness of the carotid artery.

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Authors and Affiliations

  1. Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Building Delta 6, L’Aquila, Italy

    Rita Del Pinto, Davide Grassi, Giuliana Properzi, Giovambattista Desideri & Claudio Ferri

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  1. Rita Del Pinto
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  2. Davide Grassi
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  3. Giuliana Properzi
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  4. Giovambattista Desideri
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  5. Claudio Ferri
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Contributions

RDP and CF conceived the review. RDP, DG, GP, GD and CF drafted the manuscript. GD and CF supervised the manuscript drafting. All the authors read and commented on the manuscript and gave their final approval to the submitted version of the manuscript.

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Correspondence to Rita Del Pinto.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Del Pinto, R., Grassi, D., Properzi, G. et al. Low Density Lipoprotein (LDL) Cholesterol as a Causal Role for Atherosclerotic Disease: Potential Role of PCSK9 Inhibitors. High Blood Press Cardiovasc Prev 26, 199–207 (2019). https://doi.org/10.1007/s40292-019-00323-7

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  • DOI: https://doi.org/10.1007/s40292-019-00323-7

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