Effects of Loading-Dose Statins Combined with PCSK9 Inhibitor Pre-Treatment before Primary Percutaneous Coronary Intervention on the Short-Term Prognosis in Patients with ST-Segment Elevation Myocardial Infarction

Objective: This study was aimed at investigating the effects of preoperative treatment with a loading dose of statinscombined with a PCSK9 inhibitor on coronary blood perfusion and short-term cardiovascular adverse events in patientswith ST-segment elevation myocardial infarction (STEMI).Method: Sixty-five patients with STEMI who had visited the Shanxi Cardiovascular Disease Hospital between May2018 and May 2021 were enrolled in the study. The enrolled patients had no history of oral statins or antiplatelet therapy.The patients were divided into a combined treatment group (loading dose of statins combined with PCSK9 inhibitors, 35patients) and a routine treatment group (loading dose of statins only, 30 patients). The primary endpoints were thrombolysisin myocardial infarction (TIMI) blood flow grading, corrected TIMI frame count (CTFC), and TIMI myocardial perfusiongrading (TMPG), immediately after and 30 days after the operation. The secondary endpoint was a composite endpoint ofcardiovascular death, nonfatal myocardial infarction, and target vessel revascularization 30 days after the operation.Results: The combined treatment group had significantly lower CTFC (14.09 ± 8.42 vs 26 ± 12.42, P = 0.04) and betterTMPG (2.74 ± 0.61 vs 2.5 ± 0.73, P = 0.04) than the routine treatment group immediately after the operation. Similarly,the combined treatment group had a significantly lower CTFC (16.29 ± 7.39 vs 26.23 ± 11.53, P = 0.04) and significantlybetter TMPG (2.94 ± 0.24 vs 2.76 ± 0.43, P = 0.01) than the routine treatment group 1 month after the operation.Conclusion: Preoperative treatment with a loading dose of high-intensity statins combined with PCSK9 inhibitorsincreased coronary blood flow and myocardial perfusion after emergency thrombus aspiration in patients withSTEMI. However, the treatment did not significantly decrease the incidence of cardiovascular death, nonfatal myocardialinfarction, or target vessel revascularization.