Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to inhibit pyroptosis and apoptosis, which play important roles in the development and progression of contrast-induced acute kidney injury (CI-AKI). However, to the best of our knowledge, no studies have investigated the potential effect of PCSK9 inhibitors on the prevalence of CI-AKI after percutaneous coronary intervention (PCI). This study aimed to determine whether PCSK9 inhibitors are associated with the prevalence of CI-AKI. The medical records of 309 (mean age, 63.35 years; 71.84% male) patients with acute myocardial infarction who underwent PCI at our institution were retrospectively analyzed. Overall, 149 and 160 patients were assigned to the evolocumab and control groups, respectively. Serum creatinine levels were examined preoperatively and 24–72 h postoperatively and compared between groups. Data were grouped according to the occurrence of CI-AKI, and a univariate analysis was conducted to exclude suspected influencing factors that led to CI-AKI occurrence. After adjusting for confounding factors, a logistic regression analysis was performed to assess the association between evolocumab administration (independent variable) and CI-AKI occurrence (dependent variable). The prevalence of CI-AKI was significantly lower in the evolocumab group (6.7%) than in the control group (20.0%; ).We further evaluated the correlation between exposure factor and outcome. The relative risk(RR) between the use of evolocumab and the occurrence of CI-AKI was 0.34(95% CI 0.17-0.66,p<0.01).This result indicate a significant association between the use of evolocumab and a reduction in the incidence of CI-AKI.The logistic regression analysis results revealed that evolocumab was significantly associated with CI-AKI. The use of PCSK9 inhibitors, hydration therapy, and statin administration appears promising for preventing CI-AKI in patients with acute myocardial infarction undergoing PCI.

中文翻译：

---

PCSK9抑制剂对接受介入治疗的急性心肌梗死患者对比剂所致急性肾损伤的影响

前蛋白转化酶枯草杆菌蛋白酶/kexin 9 型 (PCSK9) 抑制剂已被证明可抑制细胞焦亡和细胞凋亡，这在造影剂诱导的急性肾损伤 (CI-AKI) 的发生和进展中起重要作用。然而，据我们所知，没有研究调查 PCSK9 抑制剂对经皮冠状动脉介入治疗 (PCI) 后 CI-AKI 患病率的潜在影响。本研究旨在确定 PCSK9 抑制剂是否与 CI-AKI 的患病率相关。回顾性分析在我院行PCI的309例（平均年龄63.35岁，71.84%男性）急性心肌梗死患者的病历。总体而言，149 名和 160 名患者分别被分配到 evolocumab 组和对照组。术前和术后 24-72 小时检查血清肌酐水平，并进行组间比较。根据CI-AKI的发生情况对数据进行分组，并进行单因素分析以排除可能导致CI-AKI发生的影响因素。在调整混杂因素后，进行逻辑回归分析以评估 evolocumab 给药（自变量）和 CI-AKI 发生（因变量）之间的关联。依洛尤单抗组 (6.7%) 的 CI-AKI 患病率显着低于对照组 (20.0%; 进行逻辑回归分析以评估 evolocumab 给药（自变量）和 CI-AKI 发生（因变量）之间的关联。依洛尤单抗组 (6.7%) 的 CI-AKI 患病率显着低于对照组 (20.0%; 进行逻辑回归分析以评估 evolocumab 给药（自变量）和 CI-AKI 发生（因变量）之间的关联。依洛尤单抗组 (6.7%) 的 CI-AKI 患病率显着低于对照组 (20.0%;）。我们进一步评估了暴露因素和结果之间的相关性。使用 evolocumab 与 CI-AKI 发生之间的相对风险 (RR) 为 0.34（95% CI 0.17-0.66，p<0.01）。该结果表明使用 evolocumab 与降低发病率之间存在显着关联Logistic回归分析结果显示，依洛尤单抗与CI-AKI显着相关。使用 PCSK9 抑制剂、水合作用和他汀类药物给药似乎有望预防接受 PCI 的急性心肌梗死患者的 CI-AKI。