Key result
PCSK9 inhibitors may exert pleiotropic effects beyond LDL cholesterol lowering, potentially influencing atherosclerosis, vascular inflammation, platelet function, and other metabolic pathways.
PCSK9 inhibitors may exert pleiotropic effects beyond LDL cholesterol reduction, potentially influencing atherosclerosis, inflammation, and various non-cardiovascular conditions, which warrants further investigation.
Potential pleiotropic effects of PCSK9 inhibitors should not yet alter practice; leaves open their contribution to outcomes beyond LDL lowering.
PURPOSE OF REVIEW: Current data suggest that proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors may affect many metabolic pathways beyond lowering LDL cholesterol. The aim of the present manuscript is to present these so-called pleiotropic effects of PCSK9 inhibitors. RECENT FINDINGS: PCSK9 may affect the activity of other receptors beyond LDL receptors (LDLR), such as cluster of differentiation 36 (CD36), very-low-density-lipoprotein (VLDL) receptors, apolipoprotein (Apo) E receptors, LDLR-related protein 1 (LRP-1) and ATP-Binding Cassette Transporter (ABCA1). Thus, a role of PCSK9 in the development of atherosclerosis, in vascular wall inflammation and in platelet function has been suggested. Additionally, PCSK9 inhibitors may affect lipid variables beyond LDL cholesterol, carbohydrate variables, as well as they may affect brain and kidney function. Additionally, a controversial role of PCSK9 in sepsis, hepatitis C infection and Alzheimer's disease has been suggested. SUMMARY: These possible pleiotropic effects of PCSK9 inhibitors need further research, as they may affect cardiovascular risk and provide further insights in the development of atherosclerosis and other diseases such as Alzheimer's disease or chronic viral infection and sepsis.
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Filippatos et al. (2018) conducted a review in Atherosclerosis and cardiovascular risk. PCSK9 inhibitors was evaluated. PCSK9 inhibitors may exert pleiotropic effects beyond LDL cholesterol lowering, potentially influencing atherosclerosis, vascular inflammation, platelet function, and other metabolic pathways.
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