Association between proprotein convertase subtilisin/kexin type 9 targeted therapies and the risk of arrhythmias: a meta-analysis of randomized controlled trials
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Proprotein convertase subtilisin/kexin type 9 (PCSK9) targeted therapies effectively lower low-density lipoprotein cholesterol (LDL-C) and circulating PCSK9 levels. However, their effect on the risk of arrhythmias remains uncertain, and this meta-analysis aims to investigate the association. We performed a systematic literature search on all electronic databases for relevant randomized controlled trials (RCTs) from inception until 16th August, 2024. Primary clinical endpoint was atrial fibrillation (AFib), while the secondary endpoints were atrial flutter (AFL), ventricular fibrillation (VF), ventricular tachycardia (VT), supraventricular tachycardia (SVT), sudden cardiac death (SCD), cardiac arrest and atrioventricular blocks. 28 RCTs with 95,520 patients were finally included in the analysis. The mean age of the group treated with PCSK9 inhibitors was similar to the control group (60.13 years vs. 60.06 years). At mean follow-up of 1.6 years the PCSK9i group had similar risk of AFib (OR, 0.88; 95%CI: 0.75-1.03, p =0.11), AFL (OR, 1.04; 95%CI: 0.70-1.54, p =0.84), VT (OR, 0.80; 95%CI: 0.58-1.11, p =0.18), VF (OR, 0.77;95%CI: 0.40-1.47, p =0.43) and SVT (OR, 0.94; 95%CI: 0.56-1.58, p =0.82) compared to control group. Similarly, the SCD (OR, 0.91; 95%CI: 0.62-1.32, p =0.61), and AV block (OR, 0.72; 95%CI: 0.34-1.52, p =0.39) did not differ between the groups. This meta-analysis did not find a significant association between PCSK9i and arrhythmias.
Authors: Vikash Jaiswal, Aman Goyal, Novonil Deb, Nishat Shama, Vivek Mittal, Kripa Rajak, Anupam Halder, Sulochana Khadka, Tushar Kumar, Raheel Ahmed, Ibadete Bytyçi, Maciej Banach
Institutions: AMA School of Medicine, Cleveland Clinic, King Edward Memorial Hospital and Seth G.S. Medical College, North Bengal Medical College and Hospital, Trinity Health, Wayne State University, University of Missouri, Mount Sinai Medical Center, Columbia University, UPMC Central Pa, University of Washington, Imperial College London, University Clinical Center of Kosovo, University of Prishtina, John Paul II Catholic University of Lublin, Johns Hopkins University, University of Liverpool, Johns Hopkins Medicine, Liverpool Heart and Chest Hospital, Medical University of Lodz, Polish Mother’s Memorial Hospital Research Institute, Liverpool John Moores University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,900
Funders: Amgen, Daiichi-Sankyo
OpenAlex ID: W4414420000