The following is a summary of “PSCK9 inhibitors reduced early recurrent stroke in patients with symptomatic intracranial atherosclerotic stenosis,” published in the May 2024 issue of Neurology by Wu et al.
Intracranial atherosclerotic stenosis (ICAS), a narrowing of the brain’s arteries, increases the risk of early recurrent stroke (ERS). Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, which lower low-density lipoprotein cholesterol (LDL-C), may be beneficial in preventing ERS.
Researchers conducted a prospective study investigating the effectiveness of PCSK9 inhibitors in reducing ERS in patients with symptomatic ICAS.
They enrolled consecutive patients with acute ischemic stroke due to ICAS (October 1, 2020, and September 30, 2022), admitted within one week of onset, and followed them for one month. The patients were split into two groups, one receiving PCSK9 inhibitors as an add-on therapy (PCSK9 inhibitors group) and the other receiving statins and/or ezetimibe (control group). The ERS was primarily assessed. Cox proportional hazard models and Kaplan-Meier survival curves were utilized to analyze the relationship between PCSK9 inhibitors and ERS.
The results showed that at the end of follow-up, LDL-C levels were significantly decreased with PCSK9 inhibitors add-on therapy (n=232, from 3.06±1.16 mmol/L to 2.12±1.19 mmol/L) compared to statins and/or ezetimibe treatment (n=429, from 2.91±1.05 mmol/L to 2.64±0.86 mmol/L, P<0.001). Kaplan-Meier survival curves demonstrated a significant reduction in ERS with PCSK9 inhibitors add-on therapy (5.59%, 24/429, vs. 2.16%, 5/232; log-rank test, P=0.044). Multivariate Cox regression analysis revealed an aHR of 0.335 (95% CI 0.114 to 0.986, P=0.047) for PCSK9 inhibitors add-on therapy compared to the control group after adjusting for significant confounders.
Investigators found that PCSK9 inhibitor treatment alongside standard therapy lowered LDL-C levels and reduced the risk of early recurrent stroke in patients with symptomatic ICAS.
Source: jnnp.bmj.com/content/95/6/529
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