所属 医学部 医学科（東京女子医科大学病院） 職種 助教
|発表タイトル||Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK-9)Inhibitors Improve Lipid Profile and Vascular Atherosclerotic
Plaque Formation in High-Risk Familial Hypercholesterolemia
|会議名||ACC.18 (67th Annual Scientific Session & Expo)|
|主催者||American College of Cardiology|
|発表者・共同発表者||SEKIGUCHI Haruki, YAMAMOTO Eri, ◎KOIKE Toshiharu, ABE Takuro, SAKAI Akiko, SATO Kayoko, HAGIWARA Nobuhisa|
|学会抄録||Journal of the American College of Cardiology 71(11),Supplement A2093 2018|
|概要||Background: The effectiveness of proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors in patients with ischemic heart disease was revealed by FOURIER trials. For secondary prevention, low-density lipoprotein cholesterol(LDL-C) levels should be controlled below 70mg/dL. However, for the patients with heterozygous familial hypercholesterolemia(hFH), it is difficult to reach the target levels of LDL-C with conventional hypolipidemic drugs. We examined the effects of PCSK-9 inhibitors treated with high-risk FH patients.
Methods: From 2016, we administered PCSK-9 inhibitors to the patients with hFH. We analyzed the clinical course for first and second prevention, clinical characteristics, biochemical data, physiological examination, and gene mutation in the consecutive 16 high-risk hFH patients(8 male and 8 female) for 24W.
Results: The age of hFH patients was 59.4±13.2 years and BMI was 26.9±4.1 kg/m². We found 6 of LDLR and 3 of PCSK-9 gene mutations, and 30% of those had double heterozygous mutations. The T-cho, LDL-C, ApoB, LP(a), and oxidized LDL-C were improved significantly after PCSK-9 inhibitor treatments for 4W. In many cases, the maximum carotid artery intima-media thickness(IMT) and achilles tendon xanthoma(ATX), and coronary artery plaques were decreased dramatically after 24W.
Conclusion: The plaque formation in high-risk FH patients was improved following strong lipids-lowering effects by PCSK-9 inhibitor, it could be prevented the future cardiovascular events.