Prospects of Using PCSK9 Inhibitors for Acute Coronary Syndrome

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is an enzyme involved in the regulation of blood cholesterol levels by binding to low-density lipoprotein receptors and promoting their degradation. Pivotal studies have shown that PCSK9 inhibition by monoclonal antibodies, alirocumab and evolocumab, and the small interfering RNA (inclisiran) reduces the risk of cardiovascular diseases in individuals with coronary heart disease. However, the place of the PCSK9 inhibitors in treatment of patients with acute coronary syndrome has not been determined yet. The article discusses studies on the addition of PCSK9 inhibitors to therapy during the acute phase of myocardial infarction as well as pathophysiological prerequisites for their use.