AUTHOR=Cao Zhantao , Chen Ningjing , Chen Jun , Xu Xuejing , Zhang Zhanglu , Wang Yunsu 

TITLE=Effectiveness of combining PCSK9 inhibitors with statins on major adverse cardiovascular events and lipid levels in patients after percutaneous coronary intervention: a systematic review and meta-analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1612095

DOI=10.3389/fcvm.2025.1612095

ISSN=2297-055X

ABSTRACT=BackgroundFew percutaneous coronary intervention (PCI) patients achieve low-density lipoprotein cholesterol (LDL-C) targets with statins alone. While proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors effectively diminish LDL-C levels, their combined use with statins for reducing major adverse cardiovascular events (MACE) and improving lipid profiles post-PCI requires further validation. This study seeks to appraise the therapeutic impact of PCSK9 inhibitors combined with statins on MACE and blood lipids in patients following PCI.MethodsRandomized controlled trials (RCTs) and cohort studies as of February 2025 in the PubMed, Embase, Cochrane Library, and Web of Science databases were identified. Regarding the risk of bias evaluation, Cochrane ROB 2.0 was employed for RCTs. Moreover, cohort studies were appraised by means of the Newcastle-Ottawa Scale. In terms of heterogeneity, it was appraised by means of the I2 statistics. The relative risk (RR) and 95% confidence interval (CI) for dichotomous variables, along with the weighted mean difference (WMD), standardized mean difference (SMD), and their respective 95% CIs for continuous variables.ResultsThe meta-analysis included 17 studies, including 9 RCTs and 8 cohort studies, involving 5,607 subjects. The meta-analysis revealed that, against the statin group, the combination therapy group displayed a notable decline in MACE incidence (RR: 0.61; 95% CI: 0.50–0.75; p < 0.001; I2 = 0.0%). Meanwhile, the combination therapy group demonstrated greater LDL-C reduction vs. statin monotherapy (SMD: −1.29; 95% CI: −1.70 to −0.87). Moreover, The combination therapy group achieved significantly higher LDL-C ≤ 1.4 mmol/L attainment rates vs. statin monotherapy (RR: 5.83; 95% CI: 5.20–6.55).ConclusionPCSK9 inhibitors combined with statins significantly reduces MACE incidence, improves lipid profiles in post-PCI patients compared to statin monotherapy.Systematic Review Registrationhttps://www.crd.york.ac.uk/, identifier (CRD420250650716).