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Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

PCSK9 Inhibition & Neurocognitive Impairment

Circulation; ePub 2017 Nov 16; Mefford, et al

Exposure to low proprotein convertase subtilisin/kexin type 9 (PCSK9) levels and cumulative exposure to lower low-density lipoprotein cholesterol (LDL-C) are not associated with neurocognitive effects in African Americans, a recent study found. The study examined the association between PCSK9 loss-of-function (LOF) variants and neurocognitive impairment and decline among African American REasons for Geographic and Racial Differences in Stroke (REGARDS) participants with (n=241) and without (n=10,454) C697X or Y142X LOF variants. Researchers found:

  • The prevalence of neurocognitive impairment at any assessment was 6.3% by Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) and 15.4% by Six Item Screener (SIS) definitions.
  • Adjusted odds ratios (ORs) for neurocognitive impairment for those with vs without PCSK9 LOF variants were 1.11 using the CERAD battery and 0.89 using the SIS assessment.
  • Patterns of neurocognitive decline were similar between participants with and without PCSK9 LOF variants.


Mefford MT, Rosenson RS, Cushman M, et al. PCSK9 variants, LDL-cholesterol, and neurocognitive impairment: The REasons for geographic and racial differences in stroke (REGARDS) study. [Published online ahead of print November 16, 2017]. Circulation. doi:10.1161/CIRCULATIONAHA.117.029785.

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Eligibility for PCSK9 Inhibitors After ACS, J Am Heart Assoc; ePub 2017 Nov 9; Gencer, et al

CV Risk & Statins After MI in Young Adults, J Am Coll Cardiol; ePub 2017 Nov 14; Singh, et al