Lower body mass index is associated with the achievement of target LDL in patients using PCSK9 inhibitors in Taiwan.
Journal
European journal of medical research
Journal Volume
30
Journal Issue
1
Start Page
176
ISSN
2047-783X
Date Issued
2025-03-15
Author(s)
Tu, Kuan-Chieh
Chang, Wei-Ting
Lin, Hui-Wen
Lin, Po-Lin
Lin, Chao-Feng
Yeh, Hung-I
Charng, Min-Ji
Huang, Po-Hsun
Lin, Tsung-Hsien
Lin, Wei-Wen
Hsieh, I-Chang
Kuo, Feng-Yu
Chen, Ching-Pei
Lin, Sheng-Hsiang
Li, Yi-Heng
DOI
10.1186/s40001-025-02431-8
Abstract
OBJECTIVE: Proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors are a standard therapy for patients who respond poorly to or cannot tolerate statins. However, identifying responders to PCSK9 inhibitors remains unclear. This study investigates the characteristics of patients who achieve target LDL-C reduction (< 70 mg/dl) after PCSK9 inhibitor therapy. METHODS: A multicenter, retrospective cohort study included patients initiating PCSK9 inhibitors at 11 teaching hospitals in Taiwan (2017-2021). Baseline characteristics, lipid-lowering therapies, and lipid profile changes were analyzed. RESULTS: Among 211 patients (mean age 57.2 ± 13.1 years, 72.0% male), 73.5% used alirocumab and 26.5% used evolocumab. More than half had coronary artery disease and/or hypertension. Of these, 120 patients achieved the LDL-C target. Target achievers had a lower baseline BMI (25.8 ± 3.7 vs. 27.4 ± 4.5 kg/m2, P = 0.028) and a higher incidence of myocardial infarction and anti-platelet use compared to non-achievers. Baseline cholesterol and LDL-C levels were similar, but target achievers experienced greater LDL-C reductions (- 71.5; IQR - 81.8, - 62.2 vs. - 29.4; IQR - 38, - 10.5 mg/dl, P < 0.001), as well as decreases in triglycerides and increases in HDL-C. Glucose levels and liver enzymes did not differ significantly. Logistic regression revealed BMI as the only independent predictor of LDL-C target achievement (odds ratio: 0.899, 95% CI 0.821-0.984, P = 0.021). CONCLUSIONS: Lower BMI at baseline was associated with a higher likelihood of achieving LDL-C < 70 mg/dl after 12 weeks of PCSK9 inhibitor therapy. These findings support personalized strategies for optimizing cholesterol management in statin-intolerant patients while further investigations are required.
Subjects
BMI
LDL-C target achiever
PCSK9 inhibitor
Statin
Type
journal article