PCSK9 inhibitors reduce platelet activation by lowering LDL levels and reducing LDL receptor-mediated activation, and work synergistically with other hypolipidemic and antithrombotic drugs.
Do PCSK9 inhibitors reduce platelet activation in patients with primary hypercholesterolemia?
PCSK9 inhibitors provide pleiotropic antiplatelet effects in primary hypercholesterolemia, potentially enhancing the efficacy of concurrent antithrombotic therapies.
Proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors are a novel group of hypolipidemic drugs that are recommended particularly for high-risk hypercholesterolemia patients, including those with primary hypercholesterolemia (PH), where lifelong exposure to high low-density lipoprotein (LDL) cholesterol levels results in an elevated risk of atherosclerosis at an early age. The onset and progression of atherosclerosis is significantly influenced by activated platelets. Oxidized LDL influences platelet activation by interacting with their surface receptors and remodeling the composition of their cell membrane. This results in platelet aggregation, endothelial cell activation, promotion of inflammation and oxidative stress, and acceleration of lipid accumulation in atherosclerotic plaques. PCSK9 inhibitors reduce platelet activation by both significantly lowering LDL levels and reducing the LDL receptor-mediated activation of platelets by PCSK9. They also work synergistically with other hypolipidemic and antithrombotic drugs, including statins, ezetimibe, acetylsalicylic acid, clopidogrel, and ticagrelor, which enhances their antiplatelet and LDL-lowering effects. In this review, we summarize the currently available evidence on platelet hyperreactivity in PH, the effects of PCSK9 inhibitors on platelets, and their synergism with other drugs used in PH therapy.
Pęczek et al. (Sun,) conducted a review in Primary hypercholesterolemia. PCSK9 inhibitors was evaluated. PCSK9 inhibitors reduce platelet activation by lowering LDL levels and reducing LDL receptor-mediated activation, and work synergistically with other hypolipidemic and antithrombotic drugs.