PCSK9 Inhibitors

PCSK9 monoclonal antibodies reduce LDL-C by about 60% and have reduced cardiovascular events after ACS. Prior early in-hospital PCSK9 inhibition studies found substantial LDL-C reduction and higher target-attainment rates within 2 to 8 weeks after discharge. REPRESS includes both evolocumab and inclisiran, but this is a limitation because they lack direct head-to-head randomised trial comparison. The short-term effect of early PCSK9 inhibition on non-culprit plaque morphology after ACS remains insufficiently established. Inclisiran lowers LDL-C by approximately 50% by targeting hepatic PCSK9 production.