Effects of PCSK9 Inhibitors on Other than Low-Density Lipoprotein Cholesterol Lipid Variables

• Published in: Journal of Cardiovascular Pharmacology and Therapeutics Vol. 23; no. 1; pp. 3 - 12
• Main Authors: Filippatos, Theodosios D., Kei, Anastazia, Rizos, Christos V., Elisaf, Moses S.
• Format: Book Review Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2018
• Subjects: proprotein convertase subtilisin/kexin type 9; PCSK9 inhibitors; high-density lipoprotein; evolocumab; alirocumab; triglycerides; lipoprotein a
• ISSN: 1074-2484; 1940-4034
• DOI: 10.1177/1074248417724868

Low-density lipoprotein cholesterol (LDL-C) is a major cardiovascular risk factor, but other lipid variables such as triglycerides (TRGs), high-density lipoprotein cholesterol (HDL-C) and lipoprotein a [Lp(a)] also affect cardiovascular risk. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors significantly lower LDL-C concentration but also modestly improve the concentrations of TRGs and HDL-C and more robustly decrease Lp(a) levels. The review presents the associated mechanisms of the beneficial effects of PCSK9 inhibitors on the other than LDL-C lipid variables, including the effects on lipid/apolipoprotein secretion and clearance and the heteroexchange between lipoproteins, as well as the possible effects on other variables involved in lipid metabolism such as sortilin. Proprotein convertase subtilisin/kexin type 9 inhibitors improve the overall lipid profile, and these beneficial effects may play a role in the reduction of cardiovascular risk.