- Email: [email protected]
THE EFFECT OF PCSK9 INHIBITION ON LDL-SUBFRACTIONS IN PATIENTS WITH SEVERE LDL-HYPERCHOLESTEROLEMIA
1719 JACC March 21, 2017 Volume 69, Issue 11
Prevention THE EFFECT OF PCSK9 INHIBITION ON LDL-SUBFRACTIONS IN PATIENTS WITH SEVERE LDLHYPERCHOLESTEROLEMIA Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: Advances in Cholesterol Measurement and Management Abstract Category: 32. Prevention: Clinical Presentation Number: 1106-066 Authors: Liya Wu, Charlotte Bamberger, Elisa Waldmann, Renee Stark, Kerstin Henze, Klaus Parhofer, University Munich, Munich, Germany
Background: PCSK9 inhibitors (PCSK9i) decrease LDL-cholesterol by ~50% in hypercholesterolemia. However, it is unclear whether PCSK9i decrease all LDL-subfractions equally.
Methods: We evaluated the effect of PCSK9i on LDL-subfractions in 16 patients (63±11y, BMI 29.9±5.0kg/m²) with coronary heart disease, LDL-hypercholesterolemia and a wide range of triglyceride levels (74-469 mg/dL); all but 2 were on concomitant statin therapy. LDL-subtype distribution was determined before and after 4 and 12 weeks of treatment with Evolocumab (n=8) or Alirocumab (n=8) using density gradient ultracentrifugation (LDL1: 1.020-1.024; LDL2: 1.025-1.029; LDL3: 1.030-1.034; LDL4: 1.035-1.040; LDL5: 1.041-1.047; LDL6: 1.048-1.057; LDL7: 1.058-1.066 g/mL).
Results: PCSK9i significantly decreased LDL-cholesterol by 41% (4 weeks) and 50% (12 weeks) (mean±SD, before: 179±65 mg/dL, 4w: 107±50 mg/dL, 12w: 93±53 mg/dL). Cholesterol decreased in all subfractions (fig) but predominantly in LDL3-5. Overall, LDL subtype distribution did not change significantly (mean±SD, before vs 4 vs 12 weeks, respectively; large-buoyant LDL [LDL1+2]: 14.4±5.2% vs 14.4±5.3% vs. 13.8±4.7%; intermediate LDL [LDL3+4]: 41.0±9.7% vs 39.5±8.0% vs. 39.0±9.7%; small-dense LDL [LDL5-7]: 44.6±11.4% vs 46.2±10.8% vs. 47.1±10.6%).
Conclusions: PCSK9i (Alirocumab or Evolocumab) decrease cholesterol in all LDL-subfractions; however, the decrease is somewhat more pronounced in larger and intermediate sized LDL.
Prevention THE EFFECT OF PCSK9 INHIBITION ON LDL-SUBFRACTIONS IN PATIENTS WITH SEVERE LDLHYPERCHOLESTEROLEMIA Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: Advances in Cholesterol Measurement and Management Abstract Category: 32. Prevention: Clinical Presentation Number: 1106-066 Authors: Liya Wu, Charlotte Bamberger, Elisa Waldmann, Renee Stark, Kerstin Henze, Klaus Parhofer, University Munich, Munich, Germany
Background: PCSK9 inhibitors (PCSK9i) decrease LDL-cholesterol by ~50% in hypercholesterolemia. However, it is unclear whether PCSK9i decrease all LDL-subfractions equally.
Methods: We evaluated the effect of PCSK9i on LDL-subfractions in 16 patients (63±11y, BMI 29.9±5.0kg/m²) with coronary heart disease, LDL-hypercholesterolemia and a wide range of triglyceride levels (74-469 mg/dL); all but 2 were on concomitant statin therapy. LDL-subtype distribution was determined before and after 4 and 12 weeks of treatment with Evolocumab (n=8) or Alirocumab (n=8) using density gradient ultracentrifugation (LDL1: 1.020-1.024; LDL2: 1.025-1.029; LDL3: 1.030-1.034; LDL4: 1.035-1.040; LDL5: 1.041-1.047; LDL6: 1.048-1.057; LDL7: 1.058-1.066 g/mL).
Results: PCSK9i significantly decreased LDL-cholesterol by 41% (4 weeks) and 50% (12 weeks) (mean±SD, before: 179±65 mg/dL, 4w: 107±50 mg/dL, 12w: 93±53 mg/dL). Cholesterol decreased in all subfractions (fig) but predominantly in LDL3-5. Overall, LDL subtype distribution did not change significantly (mean±SD, before vs 4 vs 12 weeks, respectively; large-buoyant LDL [LDL1+2]: 14.4±5.2% vs 14.4±5.3% vs. 13.8±4.7%; intermediate LDL [LDL3+4]: 41.0±9.7% vs 39.5±8.0% vs. 39.0±9.7%; small-dense LDL [LDL5-7]: 44.6±11.4% vs 46.2±10.8% vs. 47.1±10.6%).
Conclusions: PCSK9i (Alirocumab or Evolocumab) decrease cholesterol in all LDL-subfractions; however, the decrease is somewhat more pronounced in larger and intermediate sized LDL.