Effects of a short-term alirocumab administration on the aortic stiffness: preliminary results

Arterial stiffness and wave reflections are widely used in observational studies to analyse the determinants of haemodynamic changes observed in various clinical conditions and to understand the pathogenesis of their cardiovascular complications. A large number of publications and several reviews documented the changes in arterial stiffness and wave reflections after various interventions, either non-pharmacological or pharmacological. Recently , the Consensus Document on the ventricular-arterial coupling in cardiac disease, recognized to pulse wave velocity (PWV) the role of most commonly used non-invasive method for studying the large artery stiffness defining it as a gold-standard. Furthermore, the document explored the meaning of arterial stiffness in heart failure and cardiovascular disease, considering extremely useful the analysis of the ventricular-arterial coupling in the assessment of therapy.  A recent systematic review including a meta-analysis of six studies that explored the effects of simvastatin, rosuvastatin, lovastatin and atorvastatin on PWV demonstrated a lower arterial PWV in treated patients in comparison with the placebo groups [standarized mean difference (SMD) = 2.31, 95% CI: 1.15–3.45, Pheterogeneity = 0.07, I = 93%] than concluding for a beneficial effect of statin therapy on arterial stiffness. Alirocumab, a human monoclonal antibody to proprotein convertase subtilisin–kexin type 9 (PCSK9), would improve cardiovascular outcomes after an acute coronary syndrome in patients receiving high-intensity statin therapy and clearly reduced the plasma level of low density lipoprotein (LDL-C) after 24-month treatment. The aim of this preliminary clinical experience was to analyze the time-course of the changing in arterial stiffness in high-risk cardiovascular patients after alirocumab administration. Three consecutive patients started with alirocumab injec-