20.500.12556/DiRROS-31319 PCSK9 inhibitors increase CD34+ but not other endothelial progenitor cells in patients with chronic coronary disease and increased Lp(a) values Background: Endothelial dysfunction is an independent predictor of cardiovascular events in patients with established atherosclerosis, while the circulating levels of endothelial progenitor cells (EPCs) reflect active endothelial function in heart failure patients. Although protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (PCSK9i) lower lipid concentration and reduce cardiovascular events, their impact on endothelial function remains poorly understood. Purpose: We aimed to examine the effect of PCSK9i on the levels of EPCs in the peripheral blood of patients with chronic coronary disease and significantly elevated lipoprotein(a) (Lp(a)) concentrations. Methods: In this randomized, double-blind, placebo-controlled trial, we included 100 statin-treated patients at least 6 months post-myocardial infarction with elevated Lp(a) values. The patients received PCSK9i or a placebo every 2 weeks for 6 months. Biochemical and flow cytometric analyses of peripheral blood mononuclear cells were performed at baseline and after 6 months. Results: Treatment with PCSK9i increased the levels of mature EPCs (CD34+ ) compared with placebo (p = 0.003). In contrast, no significant effects were observed on early EPC subtypes (CD34+ CD309+ , CD34+ CD133+ , CD133+ CD309+ , and CD133+ ; p = 0.611, p = 0.451, p = 0.739, and p = 0.161, respectively). The increase in mature EPCs (CD34+ ) levels did not correlate with changes in PCSK9 concentration. No associations were detected between changes in PCSK9 concentration and changes in levels of EPC subtypes predominantly expressing CD309, nor between changes in levels of any EPCs and lipoprotein concentration variations at baseline or at the end of the study. Conclusion: In patients with chronic coronary disease, treatment with PCSK9i increases circulating levels of mature CD34+ EPCs, without affecting other EPC subtypes. endothelial function endothelial progenitor cells CD34+ lipoprotein(a) proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (PCSK9i) myocardial infarction endotelijska funkcija CD34+ lipoprotein (a) miokardni infarkt true false true Angleški jezik Slovenski jezik Neznano 2026-07-28 09:03:06 2026-07-28 09:03:06 2026-07-29 03:47:11 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 13. 7. 2026; str. 1-12 article no. a29012564 Vol. 10 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 2512-9465 10.1055/a-2901-2564 284577027 RAZ_Ugovsek_Sabina_2026.pdf RAZ_Ugovsek_Sabina_2026.pdf 1 F0018AA54975309BC2F5BEA4B79FC20F 87ddbb049f35e59a6a3983e29b3bd1b6c762fa035899415a4f3b0669bb37697e 93e026db-8a52-11f1-b591-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=48421 https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2901-2564 1 65193353-8a52-11f1-b591-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=48420 Univerzitetni klinični center Ljubljana 0 0 0