ArticleJournal of the American Heart Association2026
Early PCSK9 Inhibitor Use Correlates With Improved Outcomes in Patients With Acute Stroke Receiving Endovascular Therapy.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundThe clinical benefits of early PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor use in patients with acute large vessel occlusion undergoing endovascular therapy (EVT) remain unclear. This study investigates whether early administration of PCSK9 inhibitors after EVT is associated with improved clinical outcomes.
methodsIn this retrospective cohort study, we consecutively screened patients with acute large vessel occlusion with successful EVT recanalization at 2 academic hospitals from January 2019 to March 2025. Participants were grouped based on receipt of evolocumab or alirocumab within 96 hours after EVT. Propensity score matching was performed to adjust for baseline covariates. The primary outcome was early artery reocclusion. Mediation analysis was conducted to explore potential links between PCSK9 inhibitors and clinical outcomes.
resultsAmong 429 eligible patients (148 in the PCSK9 inhibitors group, 281 controls), 116 matched pairs were analyzed. The incidence of early artery reocclusion was significantly lower in the PCSK9 inhibitors group compared with controls (3.4% versus 12.9%; odds ratio [OR], 0.24 [95% CI, 0.08-0.75];
conclusionsEarly PCSK9 inhibitor use after EVT in patients with acute large vessel occlusion was linked to reduced EAR and better 90-day outcomes without added adverse events.
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