The Impact of Early Initiation of Intensive Lipid- Lowering Therapy on Lipid Target Achievement and Major Adverse Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
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Keywords

Early
Intensive lipid-lowering
Patients with acute coronary syndrome undergoing PCI
Lipids
Major adverse cardiovascular events

DOI

10.26689/cr.v3i4.13260

Submitted : 2025-12-10
Accepted : 2025-12-25
Published : 2026-01-09

Abstract

Objective: This study primarily investigates the impact of early initiation of intensive lipid-lowering therapy on lipid target achievement rates and the incidence of major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods: A total of 100 patients with ACS who underwent PCI in our hospital were selected as the study subjects. They were randomly divided into a control group (treated with statin combined with ezetimibe, n = 41), study group 1 (initiated with statin combined with a PCSK9 inhibitor immediately after surgery, n = 32), and study group 2 (received routine oral statin and initiated with a combined PCSK9 inhibitor before discharge, n = 27). The safety of treatment, lipid target achievement, and differences in the incidence of cardiovascular adverse events were compared and analyzed among the three groups. Results: The treatment regimen in study group 1 demonstrated the optimal effect in improving liver and kidney function and lipid indicators, followed by study group 2, while the control group showed relatively weaker efficacy, with statistically significant differences (P < 0.05). The overall incidence of cardiovascular adverse events was 25.00% in the control group, 5.00% in study group 1, and 15.00% in study group 2, with statistically significant differences between the groups (P < 0.05), with study group 1 having the lowest incidence. Conclusion: Early intensive lipid-lowering therapy can significantly improve lipid target achievement rates and reduce the risk of MACE in patients with ACS undergoing PCI, with good safety and significant clinical implications.

References

Atwood J, 2022, Management of Acute Coronary Syndrome. Emerg Med Clin North Am, 40(4): 693–706.

Faro D, Laudani C, Agnello F, et al., 2023, Complete Percutaneous Coronary Revascularization in Acute Coronary Syndromes With Multivessel Coronary Disease: A Systematic Review. JACC Cardiovasc Interv, 16(19): 2347–2364.

Pogran E, Burger A, Zweiker D, et al., Lipid-Lowering Therapy after Acute Coronary Syndrome. J Clin Med, 13(7): 2043.

Wu X, Ye Y, Liu X, et al., 2024, Benefits of Intensive Lipid-Lowering Therapies in Patients with Acute Coronary Syndrome: A Systematic Review and Meta-Analysis. Ann Med, 56(1): 2389470.

Lewek J, Niedziela J, Desperak P, et al., 2023, Intensive Statin Therapy Versus Upfront Combination Therapy of Statin and Ezetimibe in Patients With Acute Coronary Syndrome: A Propensity Score Matching Analysis Based on the PL-ACS Data. J Am Heart Assoc, 12(18): e030414.

Okada K, Haze T, Kikuchi S, et al., 2024, Early, Intensive and Persistent Lipid-Lowering Therapy for Secondary Prevention of Acute Coronary Syndrome. J Atheroscler Thromb, 31(12): 1748–1762.

Iannuzzo G, Gentile M, Bresciani A, et al., 2021, Inhibitors of Protein Convertase Subtilisin/Kexin 9 (PCSK9) and Acute Coronary Syndrome (ACS): The State-of-the-Art. J Clin Med, 10(7): 1510.

Hirai K, Kawasaki T, Soejima T, et al., 2023, Impact of Intensive Low-Density Lipoprotein Cholesterol-Lowering Therapy on Coronary Artery Plaques in Acute Coronary Syndrome. Am J Cardiol, 2023(204): 84–91.

Yoshikawa M, Honda A, Arashi H, et al., 2024, Addition of Ezetimibe to Intensive Lipid-Lowering Therapy Is Associated With a Lower Incidence of Heart Failure in Patients With Acute Coronary Syndrome. Circ J, 88(11): 1819–1824.

Ferri N, Ruscica M, Lupo M, et al., 2022, Pharmacological Rationale for the Very Early Treatment of Acute Coronary Syndrome with Monoclonal Antibodies Anti-PCSK9. Pharmacol Res, 2022(184): 106439.