Proprotein Convertase Subtilisin/Kexin Type 9 Monoclonal Antibodies for Acute Coronary Syndrome: A Narrative Review

Ann Intern Med. 2016 May 3;164(9):600-7. doi: 10.7326/M15-2994. Epub 2016 Mar 22.

Abstract

Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) are an emerging therapy for dyslipidemia. Acute coronary events induce a dynamic increase of PCSK9 levels that may play a role in plaque vulnerability of both culprit and nonculprit coronary vessels. Growing evidence highlights a potential key role of PCSK9 antibodies in managing acute coronary syndrome. This review describes the influence of PCSK9 antibodies on plaque composition and instability, as well as the pharmacokinetic profile and the potential anti-inflammatory and antithrombotic mechanisms associated with PCSK9 inhibition that may confer benefits during the early phase of acute coronary syndrome. The authors posit a rationale for the use of PCSK9 antibodies in patients with acute coronary syndrome and highlight the need for further investigation in this area.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / therapy*
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Monoclonal / pharmacokinetics
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use*
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Immunologic Factors / pharmacokinetics
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use*
  • Lipoproteins, LDL / blood
  • PCSK9 Inhibitors*
  • Plaque, Atherosclerotic / therapy
  • Proprotein Convertase 9 / blood
  • Proprotein Convertase 9 / immunology
  • Recurrence
  • Time Factors

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Fibrinolytic Agents
  • Immunologic Factors
  • Lipoproteins, LDL
  • PCSK9 Inhibitors
  • PCSK9 protein, human
  • Proprotein Convertase 9