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Background: Intracranial atherosclerotic stenosis is a leading cause of ischemic stroke and recurrent events due to plaque instability. High-resolution magnetic resonance imaging identifies plaque enhancement as a key marker of instability. This study evaluated the efficacy of combined high-intensity statins and proprotein convertase subtilisin/kexin type 9 inhibitors in plaque stabilization.

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Objectives: This analysis evaluated the cost-effectiveness of inclisiran plus standard of care (SoC; comprising statins, ezetimibe, and fenofibrate) in primary hypercholesterolemia or mixed dyslipidemia from a Singapore healthcare system perspective. Inclisiran + SoC was separately compared with SoC, alirocumab + SoC, and evolocumab + SoC.

Methods: A lifetime Markov model in the United Kingdom (UK) was adapted to the Singapore setting.

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Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies (mAbs) have demonstrated promising effects in lowering cardiovascular incidents among patients with acute coronary syndrome. However, their influence on early platelet reactivity after primary percutaneous coronary intervention (PPCI) remains unclear.

Objectives: This research sought to investigate the effects of entirely human anti-PCSK9 antibodies on platelet function as measured by thrombelastography and 12-month postoperative results in patients receiving PPCI and treated with ticagrelor-based dual antiplatelet therapy.

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Emerging oral therapeutic strategies for inhibiting PCSK9.

Atheroscler Plus

March 2025

Department of Pharmaceutical and Pharmacological Sciences, Padova, Italy.

Pharmacological inhibition of Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) have been firmly established to be an effective approach to reduce low-density lipoprotein (LDL) cholesterol levels and cardiovascular events. Subcutaneous administration of monoclonal antibodies (evolocumab and alirocumab) every 2 or 4 weeks determined a 60 % reduction of LDL cholesterol levels, while the GalNac-siRNA anti PCSK9 (inclisiran) provided an effective lipid lowering activity (-50 %) after an initial subcutaneous dose, repeated after 3 months and followed by a maintenance dose every 6 months. Although these two approaches have the potentiality to bring the majority of patients at high and very-high cardiovascular risk to the appropriate LDL cholesterol targets, their cost and subcutaneous administration represent a strong limitation for their large-scale use.

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