坂井 晶子
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Language English
Title Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK-9)Inhibitors Improve Lipid Profile and Vascular Atherosclerotic
Plaque Formation in High-Risk Familial Hypercholesterolemia
Conference ACC.18 (67th Annual Scientific Session & Expo)
Promoters American College of Cardiology
Conference Type International society and overseas society
Presentation Type Poster notice
Lecture Type General
Publisher and common publisherSEKIGUCHI Haruki, YAMAMOTO Eri, ◎KOIKE Toshiharu, ABE Takuro, SAKAI Akiko, SATO Kayoko, HAGIWARA Nobuhisa
Date 2018/03/11
Venue
(city and name of the country)
Orlando, USA
Society abstract Journal of the American College of Cardiology 71(11),Supplement A2093 2018
Summary 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.