Abstract 13703: Sex Differences on Cardiovascular Outcomes of Pcsk9-Inhibitors: A Meta-Analysis

• Published in: Circulation (New York, N.Y.) Vol. 146; no. Suppl_1; p. A13703
• Main Authors: Rivera, Frederick B, De Luna, Deogracias V, Ansay, Marie Francesca M, Rocimo, Aubrey Melody, Alfonso, Pia Gabrielle I, Ong, Bradley Ashley, Golbin, Jem Marie P, Shah, Nishant, Santos Volgman, Annabelle
• Format: Journal Article
• Language: English
• Published: Lippincott Williams & Wilkins 08-11-2022
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.146.suppl_1.13703

BackgroundLDL-Cholesterol (LDLC) lowering therapies have been proven to significantly lower major adverse cardiovascular events (MACE) in patients with cardiovascular disease. Ideal LDL-C target levels are often not achieved using a high-dose statin and ezetimibe. The proprotein convertase subtilisin/kexin type-9 (PCSK-9) inhibitors can further reduce LDL-C and MACE, yet gender differences in LDL-C reduction remains unclear. We sought to determine if there are sex differences in efficacy outcomes of PCSK-9 inhibitors. MethodA comprehensive literature search was performed, and ongoing studies were identified using ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform. We used a PRISMA, Preferred Reporting Items for a Review and Meta-analysis and RevMan version 5.4 software to conduct a meta-analysis, heterogeneity test, and sensitivity analysis on the included studies. We established the significance level for all outcomes at a P-value of <0.05. Statistical heterogeneity was identified through forest plots and a standard Chi-squared test with a significant level of p<0.1. The extent of heterogeneity was based on the I2 statistic, wherein a value of more than 50% was interpreted as substantial heterogeneity. Fixed-effects analysis was applied in this meta-analysis. ResultsThere was a significant reduction in MACE in PCSK9 inhibitor arm vs. placebo in both males (HR 0.85, 95% CI 0.80 to 0.91, p<0.0001, and females (HR 0.86, 95% CI 0.76 to 0.96, p=0.009) (Figure). Furthermore, there was a similar significant reduction in LDLC with PCSK-9 inhibitors compared to placebo and ezetimibe for both sexes. Lastly, there was a significant reduction in LDL-C seen in both sexes when analyzed as to the frequency of PCSK9 inhibitor administration and the type of PCSK9 inhibitor given. ConclusionThis meta-analysis found no sex differences and similar efficacy in women and men in reducing MACE using PCSK-9 inhibitors.