دورية أكاديمية
أعرض في EDS

Safety and Effectiveness of Evolocumab During Acute and Sub-acute Phases of Acute Coronary Syndrome (ACS): A Systematic Review and Meta-analysis.

التفاصيل البيبلوغرافية
العنوان: Safety and Effectiveness of Evolocumab During Acute and Sub-acute Phases of Acute Coronary Syndrome (ACS): A Systematic Review and Meta-analysis.
المؤلفون: Alzarroug AF; College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU., Al Gahtani HK; College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU., Algahtani S; College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU., Alghamdi HK; College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU., Alhinti MF; College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU., Almutairi KA; College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU., Algahtani S; Adult Cardiology, King Khalid University Hospital, King Saud University, Riyadh, SAU.
المصدر: Cureus [Cureus] 2023 Feb 27; Vol. 15 (2), pp. e35514. Date of Electronic Publication: 2023 Feb 27 (Print Publication: 2023).
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Palo Alto, CA : Cureus, Inc.
مستخلص: Background: Coronary artery disease (CAD), manifested mainly as acute coronary syndrome (ACS), continues to be a major cause of mortality globally and a significant contributing factor to the global disease burden. Elevation of low-density lipoprotein cholesterol levels attributed to proprotein convertase subtilisin/Kexin type-9 (PCSK9) during and following ACS puts patients at high risk of subsequent adverse events. Evolocumab is a PCSK9 inhibitor that is associated with a significant reduction in low-density lipoprotein cholesterol (LDL-C) levels through PCSK9 inhibition in comparison to traditional statin therapy.
Methods: We conducted a systematic review and meta-analysis of literature addressing the efficacy and safety of evolocumab compared to other lipid-lowering therapies or placebo. An extensive internet-based literature search using pre-determined key phrases supported by medical sub-headings and Boolean operators was performed in October 2022 to identify literature pertinent to the research topic. The search was primarily based on the National Library of Medicine (PubMed and Clinical Trials), MEDLINE, Cochrane, and the Science direct literature databases. Subsequently, the researchers devised PICOs-based screening criteria which had to be met by each identified study for inclusion in the review and meta-analysis. Two independent reviewers conducted data stratification and quality assessment of identified studies. Statistical analysis of the primary and secondary outcomes was conducted on the Cochrane REVMAN 5.4 statistical software for randomized trials.
Results: Two thousand five hundred and seventy-six potential studies were identified for inclusion in the systematic review. Data stratification, screening, and quality assessment of these studies based on the eligibility criteria led to the exclusion of two thousand five hundred and sixty-seven studies as they did not meet the standards set. Nine randomized controlled trials progressed to numerical analysis for validity and reliability. Eight studies were included in the meta-analysis. Meta-analytical results showed a significant decrease in LDL-C changes from initiation of evolocumab therapy to 8 weeks following ACS compared to placebo. Similar results were derived in the sub-acute phase of ACS [SMD -1.95 (95% CI -2.29, -1.62)]. The meta-analysis revealed no statistically significant relationship between the risk of adverse effects, serious adverse effects, and major adverse cardiovascular events (MACE) from treatment using evolocumab in comparison to placebo [(relative risk, RR 1.04 (95% CI 0.99, 1.08) (Z = 1.53; p=0.12)].
Conclusion: Early evolocumab therapy initiation was associated with a significant decrease in LDL-C levels and was not associated with an increased risk of adverse effects in comparison to placebo.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2023, Alzarroug et al.)
References: J Am Coll Cardiol. 2011 Aug 9;58(7):704-11. (PMID: 21816305)
J Cardiol. 2020 Oct;76(4):395-401. (PMID: 32439340)
N Engl J Med. 2015 Apr 16;372(16):1500-9. (PMID: 25773607)
JAMA. 2001 Apr 4;285(13):1711-8. (PMID: 11277825)
Trials. 2010 May 25;11:61. (PMID: 20500832)
Eur Heart J. 2015 May 14;36(19):1163-70. (PMID: 25586123)
J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2889-934. (PMID: 24239923)
Eur Heart J. 2020 Jan 1;41(1):111-188. (PMID: 31504418)
Circ Cardiovasc Interv. 2019 Jan;12(1):e007411. (PMID: 30630354)
Biomedicines. 2021 Aug 23;9(8):. (PMID: 34440277)
Am J Nurs. 2010 Mar;110(3):58-61. (PMID: 20179464)
Arterioscler Thromb Vasc Biol. 2004 Aug;24(8):1454-9. (PMID: 15178557)
Clin Cardiol. 2016 Nov;39(11):670-677. (PMID: 27588731)
Circulation. 2020 Jul 28;142(4):419-421. (PMID: 32718248)
J Am Coll Cardiol. 2010 Jun 1;55(22):2435-45. (PMID: 20359842)
Open Med. 2009;3(3):e123-30. (PMID: 21603045)
Can J Cardiol. 2013 Feb;29(2):151-67. (PMID: 23351925)
Int Heart J. 2022 Jul 30;63(4):669-677. (PMID: 35831153)
J Am Coll Cardiol. 2019 Nov 19;74(20):2452-2462. (PMID: 31479722)
Circulation. 2010 Feb 23;121(7):e46-e215. (PMID: 20019324)
J Clin Lipidol. 2014 Sep-Oct;8(5):473-88. (PMID: 25234560)
Cardiovasc Ther. 2019 Nov 26;2019:8295054. (PMID: 32099582)
BMC Cardiovasc Disord. 2021 Jan 7;21(1):19. (PMID: 33413096)
J Am Coll Cardiol. 2018 Oct 23;72(17):2012-2021. (PMID: 30336824)
N Engl J Med. 2017 Apr 13;376(15):1430-1440. (PMID: 28306389)
Am J Cardiol. 2022 May 15;171:1-6. (PMID: 35314069)
N Engl J Med. 2018 Nov 29;379(22):2097-2107. (PMID: 30403574)
Sci Rep. 2021 Aug 5;11(1):15973. (PMID: 34354179)
N Engl J Med. 2017 May 4;376(18):1713-1722. (PMID: 28304224)
Eur Heart J. 2019 Jul 03;:. (PMID: 31270529)
J Urol. 2011 Mar;185(3):920-5. (PMID: 21251678)
فهرسة مساهمة: Keywords: acute coronary syndrome; adverse cardiovascular events; evolocumab; low-density lipoprotein cholesterol; proprotein convertase subtilisin/kexin type 9
تواريخ الأحداث: Date Created: 20230403 Latest Revision: 20230404
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10051038
DOI: 10.7759/cureus.35514
PMID: 37007377
قاعدة البيانات: MEDLINE
الوصف
تدمد:2168-8184
DOI:10.7759/cureus.35514