PCSK9抑制剂与心肌梗死后心室重构关系的研究进展

Research Progress on the Relationship between PCSK9 Inhibitors and Ventricular Remodeling after Myocardial Infarction

心肌梗死后心力衰竭的病死率居高不下,是急性心肌梗死后的严重并发症。心室重构是引起心力衰竭的重要病理生理过程,目前临床应用于逆转心室重构的药物主要针对交感神经系统和肾素-血管紧张素-醛固酮系统(RAAS)。新近研究发现,前蛋白转化酶枯草溶菌素9(PCSK9)抑制剂作为一种新型的降脂药,除了可以降低血浆中的低密度脂蛋白胆固醇(LDL-C)、稳定和逆转易损斑块之外,还参与调控心肌梗死后心室重构的多种机制。本文综述PCSK9抑制剂与心肌梗死后心室重构关系的基础和临床研究的最新进展。

Heart failure(HF)is a serious complication after acute myocardial infarction(AMI),with high mortality of HF after AMI at present.Ventricular remodeling is an important pathophysiological process that causes HF.At present,the clinical drugs used to reverse ventricular remodeling mainly target the sympathetic nervous system and the renin-angiotensinaldosterone system(RAAS).As novel lipid-lowering drugs,proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitors can reduce low-density lipoprotein cholesterol(LDL-C)in plasma,stabilize and reverse vulnerable plaques and significantly reduce the risk of cardiovascular events in atherosclerotic cardiovascular disease(ASCVD)patients.In addition,recent studies have found that PCSK9 inhibitors are involved in the regulation of various mechanisms of ventricular remodeling after myocardial infarction.This article systematically reviews the basic and clinical research progress of the relationship between PCSK9 inhibitors and ventricular remodeling after myocardial infarction.