TY - JOUR T1 - Proprotein convertase subtilisin/kexin 9 inhibitors in reducing cardiovascular outcomes: a systematic review and meta-analysis JF - Heart JO - Heart SP - 1149 LP - 1159 DO - 10.1136/heartjnl-2019-314763 VL - 105 IS - 15 AU - Heyue Du AU - Xiaodan Li AU - Na Su AU - Ling Li AU - Xiaoting Hao AU - Haihui Gao AU - Joey Sum-Wing Kwong AU - Per Olav Vandvik AU - Xueli Yang AU - Imola Nemeth AU - Ify R Mordi AU - Qianrui Li AU - Longhao Zhang AU - Li Rao AU - Chim C Lang AU - Jianshu Li AU - Haoming Tian AU - Sheyu Li Y1 - 2019/08/01 UR - http://heart.bmj.com/content/105/15/1149.abstract N2 - Background To evaluate the effects of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors on major adverse cardiovascular events (MACE).Methods Our systematic review included randomised controlled trials if they studied PCSK9 inhibitors in patients for primary and/or secondary prevention of cardiovascular diseases or with hypercholesterolaemia/hyperlipidaemia. Dichotomous variables from individual studies were pooled by relative risks (RR) and their 95% CIs using the random-effect model. Risk difference (RD) in the 10-year frame was also estimated using the pooled RR and the estimated baseline risk using the control group. Grading of Recommendation Assessment, Development and Evaluation was used to assess the quality of evidence.Results We included 54 trials with 97 910 patients in the analysis. Compared with controls, PCSK9 inhibitors significantly reduced the risk of MACE by 16% (RR, 0.84; 95% CI 0.79 to 0.89; RD: 47 fewer per 1000 vs 286 as the baseline risk; 95% CI 32 to 59 fewer), non-fatal myocardial infarction (MI) by 17% (RR, 0.83; 95% CI 0.74 to 0.93; RD, 35 fewer per 1000 vs 207 as the baseline; 95% CI 13 to 53 fewer) and any stroke by 25% (RR, 0.75; 95% CI 0.65 to 0.85; RD, 16 fewer per 1000 vs 61 as the baseline; 95% CI 9 to 21 fewer) with moderate quality evidence. No significant differences were found between PCSK9 inhibitors and control groups in all-cause mortality, cardiovascular death, heart failure or unstable angina with low-quality evidence.Conclusions This study demonstrated that PCSK9 inhibitors could significantly reduce the risk of MACE, non-fatal MI and stroke.Trial registration PROSPERO; CRD42017073904. ER -