Effect of PCSK9 Inhibitors on Hemostasis in Patients with Isolated Hypercholesterolemia

Background: In addition to reducing plasma lipids, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors may produce numerous nonlipid-related pleiotropic effects. The purpose of this trial was to determine the efficacy of PCSK9 inhibitors alone in patients with isolated hypercholesterolemia. Methods: The trial enrolled 21 individuals with isolated hypercholesterolemia and atherosclerosis who received alirocumab for 90 days (150 mg every two weeks). Lipids, glucose homeostasis factors, and hemostatic markers were measured in the plasma at baseline and after treatment. Results: The PCSK9 inhibitor administered to these patients reduced plasma levels/activity of fibrinogen (from 3.6 +/- 0.5 to 2.9 +/- 0.4 g/L, p < 0.01), factor VII (from 143.8 +/- 16.7 to 114.5 +/- 14.1%, p < 0.01) and plasminogen activator inhibitor-1 (PAI-1) (from 74.9 +/- 13.9 to 52.8 +/- 9.1 ng/mL, p < 0.001) without a significant reduction in von Willebrand factor levels, and it tended to prolong the partial thromboplastin and prothrombin times. Conclusion: Our findings indicate that treatment with PCSK9 inhibitors has a multipotential effect on fibrinolysis and coagulation in patients with isolated hypercholesterolemia and that this medication may have some future benefits in patients who are statin-intolerant or contraindicated to statin use.

Automated summary

The study aimed to determine the efficacy of PCSK9 inhibitors in patients with isolated hypercholesterolemia. The results showed that PCSK9 inhibitors reduced plasma levels/activity of fibrinogen, factor VII, and plasminogen activator inhibitor-1, suggesting potential benefits for patients who cannot tolerate or are contraindicated for statin use.