PCSK9 Targeted Therapy to Lower Cholesterol and Reduce Cardiovascular Events

Authors

  • Beth L. Abramson, MD, FRCPC, FACC Paul Albrechtsen Professor in Cardiac Prevention and Women’s Health Associate Professor of Medicine, University of Toronto, Division of Cardiology, St. Michael’s Hospital
  • Seana ML. Nelson, MD, MSc, FRCPC University of Toronto, Division of Cardiology, St. Michael’s Hospital

DOI:

https://doi.org/10.58931/cct.2025.114

Abstract

Cardiovascular disease (CVD) is an insidious threat that requires attention. Modifying risk factors can work toward preventing the current CVD epidemic. Elevated low-density lipoprotein cholesterol (LDL-c) is a well-established and modifiable risk factor for cardiovascular, cerebrovascular, and peripheral vascular diseases. Despite receiving maximally tolerated doses of statin therapy, many Canadian patients with CVD do not achieve LDL-c targets. Additional lipid-lowering therapies, such as ezetimibe or proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), are warranted.

This paper reviews the mechanisms of action and clinical trial evidence for contemporary lipid-lowering therapies, including PCSK9 inhibitor monoclonal antibodies such as evolocumab and alirocumab, and small interfering RNA (siRNA) modulators such as inclisiran, to aid Canadian clinicians in maintaining best practices.

Author Biographies

Beth L. Abramson, MD, FRCPC, FACC, Paul Albrechtsen Professor in Cardiac Prevention and Women’s Health Associate Professor of Medicine, University of Toronto, Division of Cardiology, St. Michael’s Hospital

Beth Abramson MD, is the Paul Albrechtsen Professor in Cardiac Prevention and Women’s Health in the Division of Cardiology at St. Michael’s Hospital, University of Toronto. Her interest is in knowledge translation, including writing guidelines to educate physicians on preventive cardiology and women’s health issues. Dr. Abramson is currently a member of the American College of Cardiology Prevention Council. She is a founding member of the Canadian Society of Vascular Medicine and was a founding member and inaugural Chair (2018-2020) of the Canadian Women’s Heart Health Alliance Education Working group. In 2015 she was awarded the prestigious Harold N. Segal award of Merit, in recognition of her many contributions to preventing heart disease amongst Canadians. Her book, Heart Health for Canadians, published in 2013, was written to help people prevent and understand heart disease. She currently directs a fellowship in Preventive Cardiology at the University of Toronto and has established a Cardiometabolic Clinic at St. Michael’s Hospital to close care gaps.

Seana ML. Nelson, MD, MSc, FRCPC, University of Toronto, Division of Cardiology, St. Michael’s Hospital

Dr. Seana Nelson, MD, MSc, FRCPC, earned her undergraduate degree and Master of Science from the University of Toronto and later completed her medical education at Queen’s University. She trained in Internal Medicine at Western University, where she was a chief resident, and finished her Cardiology training at the same institution. She is a fellow in Preventive Cardiology under Dr. Beth Abramson at St. Michael’s Hospital, Unity Health, which is affiliated with the University of Toronto.

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Published

2025-03-19

How to Cite

1.
Abramson BL, Nelson SM. PCSK9 Targeted Therapy to Lower Cholesterol and Reduce Cardiovascular Events. Can Cardiol Today [Internet]. 2025 Mar. 19 [cited 2025 Apr. 3];1(1):20–25. Available from: https://canadiancardiologytoday.com/article/view/1-1-Abramson_et_al

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Volume 1, Issue 1, Winter 2025

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