Impact of high neutrophil-to-lymphocyte ratio on the cardiovascular benefit of PCSK9 inhibitors in familial hypercholesterolemia subjects with atherosclerotic cardiovascular disease: Real-world data from two lipid units

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 31; no. 12; pp. 3401 - 3406
• Main Authors: Scicali, Roberto, Mandraffino, Giuseppe, Di Pino, Antonino, Scuruchi, Michele, Ferrara, Viviana, Squadrito, Giovanni, Purrello, Francesco, Piro, Salvatore
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 29.11.2021
• Subjects: Anticholesteremic Agents - therapeutic use; Atherosclerosis - blood; Atherosclerosis - drug therapy; Atherosclerosis - epidemiology; biomarkers; cardiovascular diseases; Cardiovascular risk; Familial hypercholesterolemia; Humans; hypercholesterolemia; Hyperlipoproteinemia Type II - blood; Hyperlipoproteinemia Type II - drug therapy; Inflammatory profile; lipids; Lymphocytes; metabolism; Neutrophil-to-lymphocyte ratio; Neutrophils; nutrition; observational studies; PCSK9 inhibitors; PCSK9 Inhibitors - therapeutic use; Pulse Wave Analysis; Pulse wave velocity; subtilisin; therapeutics; Treatment Outcome; Pulse wave velocity; PCSK9 inhibitors; Inflammatory profile; Familial hypercholesterolemia; Neutrophil-to-lymphocyte ratio; Cardiovascular risk
• ISSN: 0939-4753; 1590-3729; 1590-3729
• DOI: 10.1016/j.numecd.2021.08.034

Neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory biomarker strongly associated with atherosclerotic cardiovascular disease (ASCVD). Our aim was to evaluate the role of NLR on pulse wave velocity (PWV) after adding-on proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9-i) in familial hypercholesterolemia (FH) subjects with ASCVD. In this prospective observational study, we evaluated 45 FH subjects with ASCVD on high-intensity statins plus ezetimibe and with an off-target LDL-C. Study population was divided into two groups according to the mean value of NLR. All patients received PCSK9-i therapy and obtained biochemical analysis as well as PWV evaluation at baseline and after six months of PCSK9-i. After six months of add-on PCSK9-i therapy, a significant reduction of TC, LDL-C, Non-HDL-C, Lp(a) and ApoB plasma levels was observed in the two groups; while low-NLR group exhibited a significant PWV reduction after six-month therapy with PCSK9-i (Δ −16.2%, p < 0.05), no significant changes in PWV were observed in the high-NLR group. Only FH subjects with low-NLR experienced a significant reduction of PWV after PCSK9-i. Our findings suggest a role of NLR in predicting PCSK9-i effect in FH subjects with ASCVD. •Low NLR group exhibited a significant PWV reduction after six months of PCSK9i therapy.•No significant changes of PWV were observed in the high-NLR group after six months of PCSK9i therapy.•High-NLR may have an important role in predicting PCSK9i effects in FH subjects with ASCVD.