Statins Versus Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors for Primary Cardiovascular Prevention in High-Risk Patients: A Systematic Review

Cardiovascular disease (CVD) remains a major global health concern, emphasizing the importance of effective primary prevention strategies, especially in individuals at high risk. While statins are foundational in lipid-lowering therapy, challenges such as inadequate low-density lipoprotein cholesterol (LDL-C) control or intolerance to high-dose statins persist. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have gained attention as promising agents in this context. This systematic review explores the comparative effectiveness of PCSK9 inhibitors versus traditional statin-based regimens in high-risk individuals without established CVD. The findings suggest that PCSK9 inhibitors offer robust LDL-C lowering capabilities and may improve goal attainment in primary prevention settings. Although direct evidence of cardiovascular event reduction is still emerging, early indications are favorable, particularly in genetically predisposed populations. Overall, PCSK9 inhibitors appear to be a viable adjunctive option for patients who do not achieve optimal lipid control with statins alone.