PCSK9 inhibition
Lp(a) and oxidised phospholipids track myocardial inflammation after heart attack in a PCSK9-inhibitor trial (Nat Cardiovasc Res 2026)
Original title: Lipoprotein(a) and oxidized phospholipids are associated with myocardial inflammation after acute myocardial infarction
Analysis of patients in a randomised, double-blind trial of in-hospital PCSK9 inhibition versus placebo after acute myocardial infarction (MI), in whom PCSK9 inhibition had previously been shown to reduce myocardial inflammation. Plasma oxidised phospholipids on apoB-containing lipoproteins (OxPL-apoB), on apo(a) (OxPL-apo(a)), and Lp(a) were measured at admission and 30 days, alongside paired [18F]-fluorodeoxyglucose PET imaging of myocardial inflammatory activity. Higher OxPL-apoB, OxPL-apo(a) and Lp(a) at 30 days were associated with greater myocardial inflammatory activity, and changes in Lp(a) and OxPL-apoB from baseline to 30 days correlated positively with change in myocardial glucose uptake on PET. The findings demonstrate that Lp(a) and its oxidised phospholipid cargo track persistent myocardial inflammation after acute MI.
Original abstract
Localized myocardial inflammation after acute myocardial infarction (MI) is regulated by innate immune pathways. Oxidized phospholipids (OxPLs) carried on lipoprotein(a) (Lp(a)) are proinflammatory, but their association with myocardial inflammation during the early post-MI period has not been described. Here we study patients enrolled in a randomized, double-blind trial of in-hospital PCSK9 inhibition versus placebo, in whom this treatment decreased myocardial inflammation after MI. We analyze plasma levels of OxPLs on apolipoprotein B-100 containing lipoproteins (OxPL-apoB), OxPLs on apolipoprotein(a) (OxPL-apo(a)), and Lp(a) during hospital admission and at 30 days, and paired [18F]-fluorodeoxyglucose positron emission tomography of myocardial inflammatory activity. Higher levels of OxPL-apoB, OxPL-apo(a) and Lp(a) at 30 days were associated with greater myocardial inflammatory activity; changes in Lp(a) and OxPL-apoB from baseline to 30 days were positively correlated with the change in myocardial [18F]-fluorodeoxyglucose uptake. These findings demonstrate that Lp(a) and OxPL are associated with persistent myocardial inflammation after an acute MI.
inflammationmechanismsPCSK9 inhibition
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.