# Statins Versus Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors for Primary Cardiovascular Prevention in High-Risk Patients: A Systematic Review

**Authors:** Sangeen Khan, Ayesha Asif, Osman Omer, Muhammad Zubair Dawud Gondal, Hamza Tallal, Tajammul Abbas

PMC · DOI: 10.7759/cureus.83646 · Cureus · 2025-05-07

## TL;DR

This paper compares statins and PCSK9 inhibitors for preventing heart disease in high-risk patients, finding that PCSK9 inhibitors may be more effective in lowering cholesterol.

## Contribution

The study systematically evaluates PCSK9 inhibitors as a potential alternative or supplement to statins in primary cardiovascular prevention.

## Key findings

- PCSK9 inhibitors demonstrate strong LDL-C lowering capabilities compared to statins.
- PCSK9 inhibitors may help high-risk patients achieve cholesterol goals more effectively.
- Early evidence suggests cardiovascular benefits, especially in genetically predisposed individuals.

## Abstract

Cardiovascular disease (CVD) remains a major global health concern, emphasizing the importance of effective primary prevention strategies, especially in individuals at high risk. While statins are foundational in lipid-lowering therapy, challenges such as inadequate low-density lipoprotein cholesterol (LDL-C) control or intolerance to high-dose statins persist. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have gained attention as promising agents in this context. This systematic review explores the comparative effectiveness of PCSK9 inhibitors versus traditional statin-based regimens in high-risk individuals without established CVD. The findings suggest that PCSK9 inhibitors offer robust LDL-C lowering capabilities and may improve goal attainment in primary prevention settings. Although direct evidence of cardiovascular event reduction is still emerging, early indications are favorable, particularly in genetically predisposed populations. Overall, PCSK9 inhibitors appear to be a viable adjunctive option for patients who do not achieve optimal lipid control with statins alone.

## Linked entities

- **Proteins:** PCSK9 (proprotein convertase subtilisin/kexin type 9)
- **Diseases:** cardiovascular disease (MONDO:0004995)

## Full-text entities

- **Genes:** PCSK9 (proprotein convertase subtilisin/kexin type 9) [NCBI Gene 255738] {aka FH3, FHCL3, HCHOLA3, LDLCQ1, NARC-1, NARC1}
- **Diseases:** CVD (MESH:D002318)
- **Chemicals:** lipid (MESH:D008055)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

25 references — full list in the complete paper: https://tomesphere.com/paper/PMC12143113/full.md

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Source: https://tomesphere.com/paper/PMC12143113