PCSK9-targeted therapy initiated before hospital discharge after an acute coronary syndrome was associated with LDL goal achievement in 93% of patients at a median follow-up of 49 days.
Observational (n=43)
Does PCSK9-targeted therapy initiated before hospital discharge improve early LDL goal achievement in patients after an acute coronary syndrome?
Initiating PCSK9-targeted therapy before hospital discharge in ACS patients is associated with a high rate (93%) of early LDL goal achievement.
Abstract Background/introduction LDL cholesterol plays an essential role in lipid management after a cardiosvascular event. In patients with very high or extreme cardiovascular risk (CVR), it is required to achieve an early, intense reduction of LDL level. Nowadays, combined lipid-lowering oral therapy and PCSK9-targeted therapy (PCSK9tt) allow patients to reach their LDL goal. Its administration in patients from index hospitalisation with high CVR is key to prevent new events. Purpose To analyse the effect of PCSK9tt in LDL control at an early stage after index hospitalisation because of an acute coronary syndrome (ACS). Methods This is an observational, analytical, longitudinal, retrospective study about patients who suffered an ACS from December 2020 to September 2025 and started treatment with PCSK9tt just before hospital discharge. Personal and family history, clinical characteristics and laboratory variables were registered during index hospitalisation. LDL goal, treatment adherence and evolution of analytical variables were checked in an early follow-up visit in the rehabilitation and secondary prevention outpatient clinic. The effect of PCSK9tt was assessed comparing mean values of laboratory test variables with Student's t-test and Wilcoxon test. Results 43 patients were included, 74.4% of whom were male and whose mean age was 58.7 (11.3) years. 53.5% of patients suffered from hypertension, 79.1% from dyslipidemia and 26.6% from diabetes. Index hospitalisation ACS was ST-segment elevation myocardial infarction (STEMI) in 44.2% of cases, no-STEMI in 41.9% and unstable angina in 14%. PCSK9tt at hospital discharge was evolocumab in 72.1% of patients, alirocumab in 16.3% and inclisiran in 11.6%. In the first follow-up visit (median time of 49 days) after hospital discharge, LDL goal was achieved in 93% of patients. There was a statistically significant reduction of inflammatory and atherogenic parameters. Conclusions 1) Treatment with PCSK9tt initiated before hospital discharge of index hospitalisation was associated with an early achievement of LDL goal in patients with very high CVR after an ACS. 2) PCSK9tt therapy reduced lipidic and inflammatory parameters related to CVR.Family and personal historyFor image description, please refer to the figure legend and surrounding text. Evolution after PCSK9i treatmentFor image description, please refer to the figure legend and surrounding text.
Mariscal et al. (Mon,) conducted a observational in Acute coronary syndrome (ACS) (n=43). PCSK9-targeted therapy was evaluated on LDL goal achievement. PCSK9-targeted therapy initiated before hospital discharge after an acute coronary syndrome was associated with LDL goal achievement in 93% of patients at a median follow-up of 49 days.