Journal
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
Volume 31, Issue 12, Pages 3401-3406Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.numecd.2021.08.034
Keywords
Familial hypercholesterolemia; PCSK9 inhibitors; Pulse wave velocity; Neutrophil-to-lymphocyte ratio; Inflammatory profile; Cardiovascular risk
Funding
- Department of Clinical and Experimental Medicine
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NLR is a novel inflammatory biomarker strongly associated with ASCVD. This study found that FH subjects with low-NLR experienced a significant reduction of PWV after PCSK9-i therapy, suggesting a role of NLR in predicting PCSK9-i effects in this population.
Background and aims: Neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory biomarker strongly associated with atherosclerotic cardiovascular disease (ASCVD). Our aim was to evaluate the role of NLR on pulse wave velocity (PWV) after adding-on proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9-i) in familial hypercholesterolemia (FH) subjects with ASCVD. Methods and results: In this prospective observational study, we evaluated 45 FH subjects with ASCVD on high-intensity statins plus ezetimibe and with an off-target LDL-C. Study population was divided into two groups according to the mean value of NLR. All patients received PCSK9-i therapy and obtained biochemical analysis as well as PWV evaluation at baseline and after six months of PCSK9-i. After six months of add-on PCSK9-i therapy, a significant reduction of TC, LDL-C, Non-HDL-C, Lp(a) and ApoB plasma levels was observed in the two groups; while low-NLR group exhibited a significant PWV reduction after six-month therapy with PCSK9-i (Delta-16.2%, p < 0.05), no significant changes in PWV were observed in the high-NLR group. Conclusions: Only FH subjects with low-NLR experienced a significant reduction of PWV after PCSK9-i. Our findings suggest a role of NLR in predicting PCSK9-i effect in FH subjects with ASCVD. (C) 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
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