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Volume 14
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Article

PCSK9 Inhibitors “Fast Track” Use Versus “Stepwise” Lipid-Lowering Therapy in Patients with Acute Coronary Syndrome: A Retrospective Single-Center Study in a “Real-World” Population

by
Davide D’Andrea
1,†,
Valentina Capone
1,†,
Alessandro Bellis
1,*,†,
Rossana Castaldo
2,
Monica Franzese
2,
Gerardo Carpinella
1,
Fulvio Furbatto
1,
Fulvio La Rocca
1,
Fabio Marsico
1,
Raffaele Marfella
3,
Giuseppe Paolisso
3,
Pasquale Paolisso
3,
Carlo Fumagalli
3,
Maurizio Cappiello
4,
Eduardo Bossone
5 and
Ciro Mauro
1
1
Unità Operativa Complessa Cardiologia con UTIC ed Emodinamica, Dipartimento Reti Tempo-Dipendenti, Azienda Ospedaliera “Antonio Cardarelli”, Via A. Cardarelli n. 9, 80131 Napoli, Italy
2
Bioinformatics Lab, SDN-SYNLAB, IRCCS SDN Spa, 80143 Napoli, Italy
3
Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, University of Campania “Luigi Vanvitelli”, Piazza Miraglia, 2, 80138 Napoli, Italy
4
Department of Health Area Strategic Services, Azienda Ospedaliera “Antonio Cardarelli”, Via A. Cardarelli n. 9, 80131 Napoli, Italy
5
Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansinin. 5, 80131 Napoli, Italy
*
Author to whom correspondence should be addressed.
†
These authors equally contributed to this work.
J. Clin. Med. 2025, 14(9), 2992; https://doi.org/10.3390/jcm14092992 (registering DOI)
Submission received: 24 February 2025 / Revised: 13 April 2025 / Accepted: 19 April 2025 / Published: 26 April 2025
(This article belongs to the Special Issue Myocardial Infarction: Current Status and Future Challenges)
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Abstract

Background: The “fast track” addition (within 48 h) of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) to the optimized oral lipid-lowering therapy (LLT) during hospitalization for acute coronary syndrome (ACS) has been shown to rapidly achieve the low-density lipoprotein cholesterol (LDL-C) therapeutic targets. However, so far, its efficacy in real-world settings remains understudied. Methods: We retrospectively analyzed 128 ACS patients treated at our center, comparing “PCSK9i fast track” use within 48 h to standard “stepwise” LLT. Lipid levels and incidence of major adverse cardiovascular events (MACEs) were evaluated at 30 and 180 days. Results: The “PCSK9i fast track” group achieved significantly lower LDL-C levels at 30 days (41.5 ± 27.5 vs. 85.6 ± 35.9 mg/dL, p < 0.001) and 180 days (29.6 ± 21.0 vs. 59.0 ± 32.4 mg/dL, p < 0.001). Recommended LDL-C targets (<55 mg/dL) were met by 88.3% of the “PCSK9i fast track” group at 180 days, compared with 61.9% of controls (p < 0.001). No significant differences in MACEs were observed between groups. No adverse effects from PCSK9i use were noted. Conclusions: The “PCSK9i fast track” strategy was safe and effective in achieving LDL-C targets more rapidly than conventional approaches in real-world ACS patients.
Keywords: PCSK9i; dyslipidemia; “fast track” strategy; acute cardiovascular syndrome; LDL-C PCSK9i; dyslipidemia; “fast track” strategy; acute cardiovascular syndrome; LDL-C

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MDPI and ACS Style

D’Andrea, D.; Capone, V.; Bellis, A.; Castaldo, R.; Franzese, M.; Carpinella, G.; Furbatto, F.; La Rocca, F.; Marsico, F.; Marfella, R.; et al. PCSK9 Inhibitors “Fast Track” Use Versus “Stepwise” Lipid-Lowering Therapy in Patients with Acute Coronary Syndrome: A Retrospective Single-Center Study in a “Real-World” Population. J. Clin. Med. 2025, 14, 2992. https://doi.org/10.3390/jcm14092992

AMA Style

D’Andrea D, Capone V, Bellis A, Castaldo R, Franzese M, Carpinella G, Furbatto F, La Rocca F, Marsico F, Marfella R, et al. PCSK9 Inhibitors “Fast Track” Use Versus “Stepwise” Lipid-Lowering Therapy in Patients with Acute Coronary Syndrome: A Retrospective Single-Center Study in a “Real-World” Population. Journal of Clinical Medicine. 2025; 14(9):2992. https://doi.org/10.3390/jcm14092992

Chicago/Turabian Style

D’Andrea, Davide, Valentina Capone, Alessandro Bellis, Rossana Castaldo, Monica Franzese, Gerardo Carpinella, Fulvio Furbatto, Fulvio La Rocca, Fabio Marsico, Raffaele Marfella, and et al. 2025. "PCSK9 Inhibitors “Fast Track” Use Versus “Stepwise” Lipid-Lowering Therapy in Patients with Acute Coronary Syndrome: A Retrospective Single-Center Study in a “Real-World” Population" Journal of Clinical Medicine 14, no. 9: 2992. https://doi.org/10.3390/jcm14092992

APA Style

D’Andrea, D., Capone, V., Bellis, A., Castaldo, R., Franzese, M., Carpinella, G., Furbatto, F., La Rocca, F., Marsico, F., Marfella, R., Paolisso, G., Paolisso, P., Fumagalli, C., Cappiello, M., Bossone, E., & Mauro, C. (2025). PCSK9 Inhibitors “Fast Track” Use Versus “Stepwise” Lipid-Lowering Therapy in Patients with Acute Coronary Syndrome: A Retrospective Single-Center Study in a “Real-World” Population. Journal of Clinical Medicine, 14(9), 2992. https://doi.org/10.3390/jcm14092992

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