The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot Study
Elevated low-density lipoprotein (LDL) cholesterol is one of the leading causes of cardiovascular disease. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors reduce LDL cholesterol levels with subsequent reductions in cardiovascular morbidity. Elevated aldosterone levels are also assoc...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-06-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/10/11/2504 |
| _version_ | 1797531242673995776 |
|---|---|
| author | Elena Izkhakov Yacov Shacham Merav Serebro Iris Yaish Yonit Marcus Gabi Shefer Karen Tordjman Yona Greenman Naftali Stern Tomer Ziv-Baran |
| author_facet | Elena Izkhakov Yacov Shacham Merav Serebro Iris Yaish Yonit Marcus Gabi Shefer Karen Tordjman Yona Greenman Naftali Stern Tomer Ziv-Baran |
| author_sort | Elena Izkhakov |
| collection | DOAJ |
| description | Elevated low-density lipoprotein (LDL) cholesterol is one of the leading causes of cardiovascular disease. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors reduce LDL cholesterol levels with subsequent reductions in cardiovascular morbidity. Elevated aldosterone levels are also associated with a greater risk of cardiovascular morbidity. There are currently no published data on the impact of PCSK9 inhibitor monotherapy on the secretion of aldosterone. The aim of this study was to examine the effect of monotherapy with the PSCK9 inhibitor evolocumab on the lipid profile and aldosterone secretion level in high-risk cardiovascular patients. Lipid profile, sodium, potassium, aldosterone, cortisol, plasma renin activity, and adrenocorticotropic hormone (ACTH) levels were analyzed at baseline and after 3 months of evolocumab therapy. Each participant underwent a 250 mcg ACTH stimulation test upon study entry. Eight women and seven men were included in the study. Their median total cholesterol, LDL cholesterol, lipoprotein (a), apolipoprotein B100, and baseline and stimulated aldosterone levels were significantly lower after 3 months of evolocumab therapy. These heretofore unreported findings indicate that reductions in unstimulated and stimulated aldosterone secretion under evolocumab therapy could be associated with reductions in cardiovascular events, a possibility that warrants further investigation. |
| first_indexed | 2024-03-10T10:41:04Z |
| format | Article |
| id | doaj.art-79fbd38630364c158b053340d9eb8791 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T10:41:04Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-79fbd38630364c158b053340d9eb87912023-11-21T22:55:29ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011011250410.3390/jcm10112504The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot StudyElena Izkhakov0Yacov Shacham1Merav Serebro2Iris Yaish3Yonit Marcus4Gabi Shefer5Karen Tordjman6Yona Greenman7Naftali Stern8Tomer Ziv-Baran9Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelInstitute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelInstitute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelInstitute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelInstitute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelInstitute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelInstitute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelInstitute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, IsraelSchool of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelElevated low-density lipoprotein (LDL) cholesterol is one of the leading causes of cardiovascular disease. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors reduce LDL cholesterol levels with subsequent reductions in cardiovascular morbidity. Elevated aldosterone levels are also associated with a greater risk of cardiovascular morbidity. There are currently no published data on the impact of PCSK9 inhibitor monotherapy on the secretion of aldosterone. The aim of this study was to examine the effect of monotherapy with the PSCK9 inhibitor evolocumab on the lipid profile and aldosterone secretion level in high-risk cardiovascular patients. Lipid profile, sodium, potassium, aldosterone, cortisol, plasma renin activity, and adrenocorticotropic hormone (ACTH) levels were analyzed at baseline and after 3 months of evolocumab therapy. Each participant underwent a 250 mcg ACTH stimulation test upon study entry. Eight women and seven men were included in the study. Their median total cholesterol, LDL cholesterol, lipoprotein (a), apolipoprotein B100, and baseline and stimulated aldosterone levels were significantly lower after 3 months of evolocumab therapy. These heretofore unreported findings indicate that reductions in unstimulated and stimulated aldosterone secretion under evolocumab therapy could be associated with reductions in cardiovascular events, a possibility that warrants further investigation.https://www.mdpi.com/2077-0383/10/11/2504PCSK9 inhibitorsaldosteronecortisolhypertension |
| spellingShingle | Elena Izkhakov Yacov Shacham Merav Serebro Iris Yaish Yonit Marcus Gabi Shefer Karen Tordjman Yona Greenman Naftali Stern Tomer Ziv-Baran The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot Study Journal of Clinical Medicine PCSK9 inhibitors aldosterone cortisol hypertension |
| title | The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot Study |
| title_full | The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot Study |
| title_fullStr | The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot Study |
| title_full_unstemmed | The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot Study |
| title_short | The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot Study |
| title_sort | effect of the pcsk9 inhibitor evolocumab on aldosterone secretion among high cardiovascular risk patients a pilot study |
| topic | PCSK9 inhibitors aldosterone cortisol hypertension |
| url | https://www.mdpi.com/2077-0383/10/11/2504 |
| work_keys_str_mv | AT elenaizkhakov theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT yacovshacham theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT meravserebro theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT irisyaish theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT yonitmarcus theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT gabishefer theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT karentordjman theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT yonagreenman theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT naftalistern theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT tomerzivbaran theeffectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT elenaizkhakov effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT yacovshacham effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT meravserebro effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT irisyaish effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT yonitmarcus effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT gabishefer effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT karentordjman effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT yonagreenman effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT naftalistern effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy AT tomerzivbaran effectofthepcsk9inhibitorevolocumabonaldosteronesecretionamonghighcardiovascularriskpatientsapilotstudy |