IMR Press / RCM / Volume 22 / Issue 2 / DOI: 10.31083/j.rcm2202052
Open Access Original Research
Lipidomic profile in patients with a very high risk of atherosclerotic cardiovascular disease on PCSK9 inhibitor therapy
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1 Department of Cardiology, Tianjin Chest Hospital, 300222 Tianjin, China
2 Department of Cardiology, Tianjin Hospital, 300211 Tianjin, China
*Correspondence: dtgb8559@126.com (Bo Gao)
These authors contributed equally.
Rev. Cardiovasc. Med. 2021, 22(2), 461–467; https://doi.org/10.31083/j.rcm2202052
Submitted: 28 January 2021 | Revised: 10 April 2021 | Accepted: 14 April 2021 | Published: 30 June 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

We evaluated the lipidomic profile of patients with very high-risk atherosclerotic cardiovascular disease (ASCVD) by ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-MS). A total of 64 patients with a very high risk of ASCVD were recruited and randomLy divided into the atorvastatin group (20 mg, every night, 4 weeks) or the combined group (evolocumab, 140 mg, once every 2 weeks on top of atorvastatin (20 mg per day)). The level of serum lipids was detected before and after treatment for 4 weeks. The lipid classes of triacylglycerols, cholesteryl esters, and sphingomyelins were analyzed using an ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry system. There were 32 patients in each group. After 4 weeks of treatment, the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in both groups and the level of lipoprotein-a (Lp-a) in the combined group were lower. In the combined treatment group, the levels of TC, LDL-C, and Lp-a decreased significantly (P < 0.05) after 4 weeks of treatment. Most of the lipid classes in plasma decreased in the combined group at 4 weeks, especially sphingolipids. Only 1 patient had an adverse event (a rash) in the combined group, which improved after anti-allergic treatment. PCSK9 inhibitors can rapidly and effectively reduce most lipid classes in patients with very-high-risk ASCVD.

Keywords
PCSK9
Lipidomics
Atherosclerotic cardiovascular disease
Lipoproteins
Sphingolipids
Lipoprotein-a
Drug therapy
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