Acute impact of the early application of alirocumab on lipoprotein (a) and interleukin-6 in patients with unstable angina pectoris: a retrospective before-after study

Abstract

Background Lipoprotein (a) is a determined causal risk factor for residual risks of recurrent ischemic cardiovascular events. Alirocumab has been found to reduce lipoprotein (a) levels. However, its effects on lipoprotein (a) and inflammation marker in a Chinese population with unstable angina remain to be characterized. Aim We aimed to assess the effect of alirocumab on lipoprotein (a) and inflammatory marker in Chinese subjects with unstable angina. Method In a retrospective before-after study, lipoprotein (a), interleukin-6 and other lipid profiles were measured before and after 4 weeks of alirocumab treatment in 53 patients with unstable angina (UA) who had already received oral lipid-lowering therapies. Results The alirocumab significantly lowered the levels of lipoprotein (a) (−11.28 mg/dL; p< 0.001) and interleukin-6 (-1.65 pg/mL; p < 0.001) after treatment. Moreover, there was a positive linear correlation between lipoprotein (a) and interleukin-6 at baseline (R=0.86; p < 0.001). Furthermore, in 11 patients with lipoprotein (a) levels ≥ 50 mg/dL at baseline, lipoprotein (a) (-27.37 mg/dL; p < 0.001) and interleukin-6 (-2.97 pg/mL; p < 0.001) decreased after treatment. In 42 patients with lipoprotein (a) levels < 50 mg/dL at baseline, lipoprotein (a) (-7.07 mg/dL; p = 0.001) and interleukin-6 (-1.31pg/mL, p < 0.001) also decreased after treatment. Conclusions Early application of alirocumab may be effective in reducing the levels of lipoprotein (a) and interleukin-6 in Chinese patients with unstable angina in the short term, especially in patients with lipoprotein (a) ≥ 50 mg/dL.