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  4. Vol 6, Issue 2, 2025

Multidimensional Modulation of PCSK9 Inhibitors in the Therapeutic Management of Ischemic Stroke

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DOI: 10.23977/medsc.2025.060201 | Downloads: 14 | Views: 383

Author(s)

Xinyi Cui 1, Hai Lin 2

Affiliation(s)

1 Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
2 The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xi'an, Shaanxi, China

Corresponding Author

Hai Lin

ABSTRACT

Proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of lipid metabolism, exacerbates ischemic stroke pathogenesis by promoting Low-Density Lipoprotein (LDL) receptor degradation, elevating Low-Density Lipoprotein Cholesterol (LDL-C) levels, and amplifying vascular inflammation and platelet activation. PCSK9 inhibitors counteract these effects through multifaceted mechanisms: reducing LDL-C, suppressing endothelial inflammation, inhibiting thrombus formation, and stabilizing atherosclerotic plaques. Clinical studies underscore their efficacy in lowering cardiovascular and ischemic stroke risks, with agents like Alirocumab and Evolocumab demonstrating robust plaque-modifying properties. While the efficacy of PCSK9 inhibitors, particularly when combined with statins, has been robustly validated across clinical studies, their safety profile reveals nuanced challenges. Adverse events such as muscle-related toxicity and new-onset diabetes demonstrate no statistically significant risks in most trials; however, neurocognitive implications remain contentious, with conflicting evidence requiring mechanistic clarification. Future research must bridge molecular insights with clinical translation, emphasizing the role of PCSK9 in neurovascular crosstalk and systemic inflammation. Advancing beyond lipid-centric strategies to holistic neurovascular network modulation could redefine therapeutic paradigms, necessitating interdisciplinary efforts to optimize precision therapies for ischemic stroke.

KEYWORDS

PCSK9 Inhibitors; Ischemic Stroke; Lipid Metabolism; Inflammation; Thrombosis; Plaque Stabilization

CITE THIS PAPER

Xinyi Cui, Hai Lin, Multidimensional Modulation of PCSK9 Inhibitors in the Therapeutic Management of Ischemic Stroke. MEDS Clinical Medicine (2025) Vol. 6: 1-7. DOI: http://dx.doi.org/10.23977/medsc.2025.060201.

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