Key result
PCSK9 inhibitors linked to ~21% reduction in epicardial adipose tissue thickness at 6 months.
Why the study?
The effect of PCSK9 inhibitors on epicardial adipose tissue thickness has not yet been determined despite their known benefits in lowering LDL cholesterol and cardiovascular events.
Do PCSK9 inhibitors reduce epicardial adipose tissue thickness in treated patients?
Cohort (n=24)
Do PCSK9 inhibitors reduce epicardial adipose tissue thickness in treated patients?
Treatment with PCSK9 inhibitors for 6 months significantly reduces epicardial adipose tissue thickness, though this reduction did not correlate with the degree of lipid decrease.
PCSK9 inhibitors were associated with EAT thickness reduction in this small series; hypothesis-generating and should not yet alter practice.
Introduction Epicardial adipose tissue (EAT) is clinically related to atherosclerosis and increased cardiovascular risk. The proprotein convertase subtilisin/kexin type 9 inhibitors (IPCSK9) are a novel group of effective drugs for lowering LDL cholesterol and cardiovascular events, however their effect on EAT has not yet been determined. Objective To assess the effect of treatment with PCSK9 inhibitors on epicardial adipose tissue. Methods The study enrolled 41 patients under treatment with PCSK9 inhibitors. At the end of the study only 24 patients were included, who were measured thickness of epicardial adipose tissue (TEAT) by transthoracic echocargiogram (just an echocardiographer using Siemens Acuson SC 2000 Prime with two-dimensional 4V1c transducer in two projections: long parasternal axis in the pericardial space of the outer edge of the myocardium above the right ventricle and in a short parasternal axis at the height of papillary muscles on the right ventricle, in telesystole and averaging three measurements; It was measured in millimeters.) using in 2 times before and after 6 months of initiation of treatment. Results Of 24 patients, 16 patients recieved evolocumab and 8 alirocumab patients; the mean TEAT pre-treatment and post-treatment was 6.84 mm (1.97) and 5.41 mm (1.86), respectively (p=0.0001); The mean percentage of change of the TEAT after 6 months of treatment was −20.39 (17.20). The mean serum LDL cholesterol levels pre-treatment and post-treatment were 188.04 mg/dL (144.0) and 94.96 mg/dL (106.04), respectively (p=0.0001); The mean change in LDL cholesterol was −51.89 (22.81). Just one patient had myocardial infarction. There was no difference between the means of reducing the percentage of change in epicardial adipose thickness between evolocumab and alirocumab. There was no correlation between lipid decrease and TEAT. Conclusion There is a significant reduction after 6 months of treatment with PSCK9 inhibitors in thickness of epicardial adipose tissue. Effect of IPCSK9 in TEAT and Lipids Funding Acknowledgement Type of funding source: None
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Gálvez et al. (2020) conducted a cohort in Patients under treatment with PCSK9 inhibitors (n=24). PCSK9 inhibitors (evolocumab and alirocumab) vs. Pre-treatment baseline was evaluated on Thickness of epicardial adipose tissue (TEAT) (p=0.0001). Treatment with PCSK9 inhibitors for 6 months significantly reduced epicardial adipose tissue thickness from a mean of 6.84 mm to 5.41 mm (p=0.0001).
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