Circulation: PCSK9 inhibits effect soning of venous thromboembolism (VTE)

The relationship between cholesterol levels and the risk of venous thromboembolism (VTE) is uncertainThe purpose of this study was to explore the effects and potential mechanisms of PCSK9 (type 9 pre-protein-conversion enzyme bacillus/kexin) inhibition on VTE risk, and to assess the efficacy of PCSK9 inhibition in subgroups with clinical and genetic riskresearchers conducted an after-the-fact analysis of the FOURIER trial that studied whether evolocumab reduced the risk of VTE events, and combined data from FOURIER and ODYSSEY OUTCOMES (cardiovascular prognosis study after alirocumab treatment for acute coronary syndrome) to assess the effects of PCSK9 inhibition on VTE riskIn addition, the researchers conducted exploratory genetic analysis of the subjects of the FOURIER trial to determine whether the VTE multigene risk score could help identify high-risk patients who could achieve the greatest VTE reduction from the evolocumab treatmentin the FOURIER trial, the VTE risk ratio (HR) of patients treated with evolocumab was 0.71 (95% CI, 0.50-1.00; P-0.05), no significant effect in the first year (HR, 0.96 (95% CI, 0.57-1.62), but after one year HR decreased by 46% (HR, 0.54 (95% CI, 0.33-0.88); Meta analysis by FOURIER and OUTCOMEODYSSEYs showed a 31% reduction in the relative risk of VTE suppressed by PCSK9 (HR, 0.69 (95% CI, 0.53-0.90); Basic LDL cholesterol levels were not associated with a reduction in VTE riskConversely, for patients with high levels of primary lipoproteina (Lpa), evolocumab therapy reduced their Lpa by 33 nmol/L and reduced the risk of VTE by 48% (HR, 0.52 (95% CI, 0.30-0.89); However, for patients with low levels of basic Lpa, evolocumab treatment reduced their Lpa by only 7 nmol/L and had no effect on their VTE riskThere is a significant correlation between lpa concentration and VTE risk reduction by modeling Lpa as a continuous variableThe multigene risk score identifies patients who more than doubled their risk of VTE, as well as those who benefited more from the evocumcumab treatmentPCSK9 suppression can significantly reduce the risk of VTELpa reduction may be an important medium for this effect