Effects of evolocumab combined with L-carnitine on prognosis of patients after emergency PCI

Patients with acute coronary syndrome still face a high risk of cardiovascular event recurrence after percutaneous coronary intervention (PCI). Evolocumab, as a PCSK9 inhibitor, can effectively reduce low-density lipoprotein cholesterol, while L-carnitine has the effect of improving myocardial energy metabolism. This study aims to investigate the effects of evolocumab combined with L-carnitine on the prognosis of patients after emergency PCI. A retrospective cohort study was conducted, including 146 patients with acute coronary syndrome who underwent emergency PCI in our hospital from January 2022 to December 2023. According to the postoperative medication regimen, patients were divided into two groups: the combination therapy group (n=76) received evolocumab combined with L-carnitine treatment, and the control group (n=70) received conventional drug therapy. After 6 months of follow-up, lipid levels, cardiac function parameters, major adverse cardiovascular events (MACE) incidence, and safety indicators were observed in both groups. Compared with the control group, patients in the combination therapy group showed significantly reduced low-density lipoprotein cholesterol levels at 6 months postoperatively [(1.4±0.3) mmol/L vs (2.1±0.5) mmol/L, P<0.01], and significantly improved left ventricular ejection fraction [(58.2±6.4)% vs (53.7±7.1)%, P<0.05]. The MACE incidence in the combination therapy group was significantly lower than that in the control group (7.9% vs 18.6%, P<0.05), mainly reflected in reduced angina recurrence rate and revascularization rate. There was no statistically significant difference in adverse reaction incidence between the two groups (P>0.05). Evolocumab combined with L-carnitine can effectively improve lipid metabolism and cardiac function in patients after emergency PCI, significantly reduce MACE incidence, and has good safety profile.