Objective: To assess the effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor (evolocumab) on blood lipid level, lipoprotein particles, and their subfractions with Nuclear Magnetic Resonance (NMR) spectroscopy in patients with acute coronary syndromes(ACS).Methods: A total of 99 consecutive patients with ACS and poor lipid control were enrolled and assigned to either the experimental group (n = 54) or the control group (n = 45). The combination therapy of PCSK9 inhibitor (Repatha ® , 140mg, q2w) and moderate statin (rosuvastatin, 10 mg, qn) was administered in the experimental group, with moderate statin therapy (rosuvastatin, 10 mg, qn) alone in the control group. The therapeutic effects on blood lipid levels and lipoprotein particle subfractions were assessed with NMR spectroscopy after eight weeks of treatment, and the achievement of LDL-C treatment target in both groups was analyzed.Results: In the experimental group, after eight weeks of evolocumab and moderate statin combination therapy, the level of blood lipids (TC, LDL-C and its subfractions [LDL-1 to 6], VLDL-C and its subfractions [VLDL-1 to 5], IDL-C, and HDL-C), lipoprotein particles, and their subfractions (VLDL-P, IDL-P, LDL-P, and its subfractions [LDL-P1 to 6], apoB, and LP(a)) demonstrated therapeutic benefits with statistical significance (P < 0.05). Lowered level of LDL-P was attributed to the significant decrease of small LDL-P (LDL-P5+6), which was significantly more prominent than the decrease in medium LDL-P (LDL-P3+4) and large LDL-P (LDL-P1+2) (P < 0.001). According to lipid control target recommended by the latest China Cholesterol Education Program (CCEP) Expert Consensus in 2019, the percentage of patients reaching the treatment target differed significantly between the experimental group and the control group (96.3% and 13.3%, respectively, P < 0.001).Conclusions: PCSK9 inhibitor treatment for 8 weeks could significantly improve the plasma lipid profiles in ACS patients with poor lipid control, and significantly decrease the concentration of lipoprotein particles which could result in atherosclerosis.

Background Triglyceride and glucose index (TYG) and triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-c) not only were significant association with hypertension, but also were related to prehypertension. However, few of these studies have large subjects to study the relationship between TyG ,TG/HDL and hypertension, prehypertension in the same population. Therefore, We conducted a large cross-sectional study to explore the association of TG/HDL-c, TyG index with prehypertension and hypertension in the same normoglycemic subjects from China, Tianjin . Methods A total of 32,124 adults were eligible for this study. According to the level of blood pressure, the enrolled individuals were divided into three groups, Which were normotension, prehypertension and hypertension. All participants completed a questionnaire, followed by a physical examination and blood sample test. Spearman’s correlation analysis was used to determine the correlation between TyG index, TG/HDL-c and their related parameters, Multiple Logistic regression analyses were applied to explore the association of TyG indexes and TG/HDL quartiles with prehypertension and hypertension. Results The association between TyG index ,TG/HDL-c and age, heart rate(HR),Body Mass Index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), total cholesterol(TC), triglycerides(TG), LDL-cholesterol(LDL-c), fasting glucose(GLU) were positive correlation, while HDL-cholesterol(HDL-c) was negative correlation in spearman correlation analysis(p < 0.001). In multiple logistic regression analysis, there was a significant difference in the risk of prehypertension and hypertension when comparing the highest TyG index to the lowest TyG index and corresponding ORs were 1.795(1.638,1.968) and 2.439(2.205,2.698), respectively. For TG/HDL-c, the corresponding ORs were 1.514(1.382,1.658) and 1.934(1.751,2.137), respectively. Furthermore, When comparing the fourth quartile to the first quartile of TyG and TG/HDL, respectively, and both corresponding ORs of hypertension were higher than prehypertension. Conclusions Elevated TyG index and TG/HDL-c levels were associated with an increased risk of incident Prehypertension and Hypertension in normoglycemic individuals. They have the potential to become cost-effective and complementary monitors in the hierarchical management of prehypertension and hypertension.

ObjectiveTo assess the effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor (evolocumab) on blood lipid level, lipoprotein particles, and their subfractions with Nuclear Magnetic Resonance (NMR) spectroscopy in patients with acute coronary syndromes(ACS). MethodsA total of 99 consecutive patients with ACS and poor lipid control were enrolled and assigned to either the experimental group (n = 54) or the control group (n = 45). The combination therapy of PCSK9 inhibitor (Repatha®, 140mg, q2w) and moderate statin (rosuvastatin, 10 mg, qn) was administered in the experimental group, with moderate statin therapy (rosuvastatin, 10 mg, qn) alone in the control group. The therapeutic effects on blood lipid levels and lipoprotein particle subfractions were assessed with NMR spectroscopy after eight weeks of treatment, and the achievement of LDL-C treatment target in both groups was analyzed. ResultsIn the experimental group, after eight weeks of evolocumab and moderate statin combination therapy, the level of blood lipids (TC, LDL-C and its subfractions [LDL-1 to 6], VLDL-C and its subfractions [VLDL-1 to 5], IDL-C, and HDL-C), lipoprotein particles, and their subfractions (VLDL-P, IDL-P, LDL-P, and its subfractions [LDL-P1 to 6], apoB, and LP(a)) demonstrated therapeutic benefits with statistical significance (P < 0.05). Lowered level of LDL-P was attributed to the significant decrease of small LDL-P (LDL-P5+6), which was significantly more prominent than the decrease in medium LDL-P (LDL-P3+4) and large LDL-P (LDL-P1+2) (P < 0.001). According to lipid control target recommended by the latest China Cholesterol Education Program (CCEP) Expert Consensus in 2019, the percentage of patients reaching the treatment target differed significantly between the experimental group and the control group (96.3% and 13.3%, respectively, P < 0.001). ConclusionsPCSK9 inhibitor treatment for 8 weeks could significantly improve the plasma lipid profiles in ACS patients with poor lipid control, and significantly decrease the concentration of lipoprotein particles which could result in atherosclerosis.