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    PCSK9 Inhibitors: A 5-Question Quiz

     

    Answer: B.

    Isn’t it a mouthful?

    Finally, to answer the question about the patient introduced earlier: Yes, he is most definitely a candidate for PCSK9 inhibitor therapy.  For this patient, he has already had clinical ASCVD (an MI) and he continues to have elevated LDL-C despite maximal dose of high intensity statin and ezetemibe. It is likely that he has HeFH driving his hyperlipidemia and PCSK9 inhibitors would be the most reasonable next step in optimal secondary prevention therapy.

     
    References

    1. Yuan G, Wang J, Hegele RA. Heterozygous familial hypercholesterolemia: an underrecognized cause of early cardiovascular disease. CMAJ : Canadian Medical Association Journal. 2006;174:1124-1129.

    2. Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. 2017; 376:1713-1722. DOI: 10.1056/NEJMoa1615664.

    3. Giugliano RP, Pedersen TR, Park J-G, et al. Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial. The Lancet. 2017;390:1962-1971.

    Payal Kohli, MD
    Payal Kohli, MD, is an attending cardiologist for Kaiser Permanente in Denver, Colorado.

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