Table 1.
Summary of studies investigating the effects of PCSK9 inhibitors or PCSK9 levels on platelet function parameters. PH: primary hypercholesterolemia, FH: familial hypercholesterolemia, LDL-C: low-density lipoprotein cholesterol, sP-selectin: soluble P-selectin, sCD40L: soluble CD40 ligand.
| PCSK-9 Inhibitor | Population | Effect | Ref. |
|---|---|---|---|
| Monotherapy | |||
| Alirocumab/evolocumab | Patients with PH (n = 7) | Decrease in P-selectin exposure, with and without agonists | [24] |
| Alirocumab/evolocumab | Patients with hypercholesterolemia (n = 21) | Reduced platelet reactivity to agonists | [95] |
| Alirocumab | Patients with FH (n = 736) | LDL-C lowering | [81] |
| Evolocumab | Patients with FH (n = 331) | LDL-C lowering | [92] |
| 10-Dehydrogingerdione | Rabbits (n = 30) | Decrease in sP-selectin and sCD40L | [93] |
| PCSK9 deficiency | Mice (n = 20) | Lowered risk of venous thrombosis | [94] |
| Polytherapy | |||
| Alirocumab + statin (unspecified) | Patients with hypercholesterolemia (n = 18,924) | Decreased risk of thrombotic events | [110] |
| Evolocumab + statin (unspecified) | Patients after acute coronary syndrome (n = 18,924) | Decreased risk of venous thromboembolism | [111] |
| Evolocumab + rosuvastatin | Patients with de novo acute coronary artery disease (n = 64) | Stabilization of atherosclerotic plaque | [108] |
| Loss-of-funcion mutation in PCSK9 gene + statin (unspecified) | Patients with hypercholesterolemia (n = 2388) | Improved response to statin therapy | [103] |
| Alirocumab/evolocumab + aspirin | Patients with PH (n = 14) | Decrease in P-selectin exposure, with and without stimuli | [24] |
| Alirocumab + aspirin | In vitro study (n = 10) | Decrease in platelet aggregation | [79] |
| Lower levels of PCSK9 + ticagrelor | Patients with acute coronary syndrome (n = 333) | Decrease in platelet aggregation | [122] |