Kosin Medical Journal

Original article

Early effects of PCSK9 inhibitors: evolocumab versus alirocumab: Su-Hyun Bae, Bong-Joon Kim, Soo-Jin Kim, Sung-Il Im, Hyun-Su Kim, Jung-Ho Heo; Kosin Med J. 2025;40(1):49-54. Published online March 27, 2025; DOI: https://doi.org/10.7180/kmj.24.145

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Background
The significance of risk modification in patients with acute coronary syndrome (ACS) is well recognized; however, the optimal timing for adminstering PCSK9 inhibitors remains unclear. Additionally, the lipid-lowering efficacy of evolocumab and alirocumab has not been fully established. This study evaluated the lipid-lowering effects of these two PCSK9 inhibitors.
Methods
Patients diagnosed with ACS, including unstable angina, ST-segment elevation myocardial infarction, and non-ST-segment elevation myocardial infarction, who were treated with a PCSK9 inhibitor (evolocumab or alirocumab) during hospitalization for ACS between 2021 and 2023 were retrospectively analyzed. Baseline low-density lipoprotein cholesterol (LDL-C) levels were assessed, and changes in LDL-C levels during the acute and subacute phases after PCSK9 inhibitor administration were compared between the evolocumab and alirocumab groups.
Results
Among 80 patients diagnosed with ACS, 36 received evolocumab, while 44 were treated with alirocumab. The mean baseline LDL-C level was 123 mg/dL in the evolocumab group and 128 mg/dL in the alirocumab group (p=0.456). In the subacute phase, the mean follow-up LDL-C levels were 47.05 mg/dL in the evolocumab group and 49.5 mg/dL in the alirocumab group (p=0.585). The mean percentage reduction in LDL-C levels during the subacute phase was 60.41% in the evolocumab group and 58.51% in the alirocumab group (p=0.431). These differences were not statistically significant.
Conclusions
No significant differences were observed between evolocumab and alirocumab. LDL-C levels exhibited a similar trend, characterized by a rapid decline in the acute phase, followed by a slight rebound in the subacute phase.

Citations

Citations to this article as recorded by

Efficacy and safety of proprotein convertase subtilisin/kexin type 9 inhibitors for adults with familial hypercholesterolemia: A network meta-analysis
Weiwei Ding, Lingyao Sun, Yun Shi, Lei Tian
International Journal of Cardiology Cardiovascular Risk and Prevention.2026; 28: 200568. CrossRef

Case reports

Dynamic Change of Ischemic Mitral Regurgitation in a Patient with Acute Coronary Syndrome: Hye Ree Kim, Min Gyu Kang, Kyehwan Kim, Hyun Woong Park, Jin-Yong Hwang, Jeong Rang Park; Kosin Med J. 2020;35(1):47-51. Published online June 30, 2020; DOI: https://doi.org/10.7180/kmj.2020.35.1.47

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Abstract PDF PubReader ePub: Ischemic mitral regurgitation (IMR) is commonly known as a chronic complication of left ventricular remodeling due to coronary artery disease. Acute IMR after coronary artery disease, such as acute myocardial infarction particular, could also develop as a mechanical complication involving papillary muscle rupture. However, the clinical significance of acute transient IMR and the therapeutic intervention in coronary artery disease is infrequently reported. We describe a patient with acute pulmonary edema due to acute IMR, which resolved immediately after coronary revascularization.

Spontaneous Coronary Artery Dissection in a female patient with fragile X syndrome: Hyun-Young Park, Jin-Man Cho, Dong-Hee Kim, Chang-Bum Park, Chong-Jin Kim; Kosin Med J. 2017;32(2):240-243. Published online January 19, 2017; DOI: https://doi.org/10.7180/kmj.2017.32.2.240

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Abstract PDF PubReader ePub

We report a case of Spontaneous coronary artery dissection associated with fragile X syndrome. The relationship between fragile X syndrome and Spontaneous coronary artery dissection is unclear. However, More research will need about the causes and treatment of Spontaneous coronary artery dissection.

Citations

Citations to this article as recorded by

Hypermobile Ehlers-Danlos syndrome (hEDS) phenotype in fragile X premutation carriers: case series
Nattaporn Tassanakijpanich, Forrest J McKenzie, Yingratana A McLennan, Elisabeth Makhoul, Flora Tassone, Mittal J Jasoliya, Christopher Romney, Ignacio Cortina Petrasic, Kaye Napalinga, Caroline B Buchanan, Paul Hagerman, Randi Hagerman, Emily L Casanova
Journal of Medical Genetics.2022; 59(7): 687. CrossRef
Exploring the Genetic Architecture of Spontaneous Coronary Artery Dissection Using Whole-Genome Sequencing
Ingrid Tarr, Stephanie Hesselson, Siiri E. Iismaa, Emma Rath, Steven Monger, Michael Troup, Ketan Mishra, Claire M.Y. Wong, Pei-Chen Hsu, Keerat Junday, David T. Humphreys, David Adlam, Tom R. Webb, Anna A. Baranowska-Clarke, Stephen E. Hamby, Keren J. Ca
Circulation: Genomic and Precision Medicine.2022;[Epub] CrossRef
Spontaneous Coronary Artery Dissection in Females With the Fragile X FMR1 Premutation
Forrest J. McKenzie, Nattaporn Tassanakijpanich, Kelly C. Epps, S. Kimara March, Randi J. Hagerman
JACC: Case Reports.2020; 2(1): 40. CrossRef
Cardiovascular Problems in the Fragile X Premutation
Nattaporn Tassanakijpanich, Jonathan Cohen, Rashelle Cohen, Uma N. Srivatsa, Randi J. Hagerman
Frontiers in Genetics.2020;[Epub] CrossRef

Original article

Platelet Cytoplasmic Ca2+ Concentration in Patients with Acute Coronary Syndromes: Jae Woo Lee, Seung Jae Joo, Tae Joon Cha, Kwan Pyo Hong, Ho Dae Yoo; The Journal of Kosin Medical College. 1997;12(1-2):11-18.

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