BACKGROUND AND AIMS We aimed to investigate potential eligibility for proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors in patients with coronary artery disease and dyslipidaemia according to patient characteristics and variable criteria. METHODS We prospectively enrolled 2000 patients (acute coronary syndrome = 407, chronic coronary artery disease inpatients = 1087, outpatient Lipid's clinic = 506). To calculate PCSK-9 inhibitors real-world eligibility, a proprietary adjustable software was developed, which stores data and patient characteristics and can determine eligibility depending on different criteria. We tested four scenarios with different LDL thresholds according to ESC/EAS 2016 and 2019 Guidelines, 2017 American College of Cardiology Expert Consensus, and National criteria. RESULTS The eligible percentage was 18.85%, 9.75%, 8.55% and 2.15%, in the total population for the four classifications, respectively, and it varied according to clinical status. The increase toward more recent guidelines was mostly attributed to the increasing number of coronary patients who become eligible as our criteria become stricter. CONCLUSIONS For the first time, a realistic estimation of PCSK-9 eligibility is provided via an adjustable predictive model in a population of 2000 patients with acute coronary syndrome, chronic coronary artery disease and dyslipidaemia. This can be a valuable tool for the incorporation of PCSK-9 inhibitors in health care systems.

中文翻译：

---

PCSK-9抑制剂治疗急性冠脉综合征、慢性冠状动脉疾病和门诊血脂异常患者的资格

背景和目的 我们旨在根据患者特征和可变标准，研究在冠状动脉疾病和血脂异常患者中使用前蛋白转化酶枯草杆菌蛋白酶 9 (PCSK9) 抑制剂的潜在资格。方法 我们前瞻性地招募了 2000 名患者（急性冠状动脉综合征 = 407，慢性冠状动脉疾病住院患者 = 1087，Lipid 诊所门诊患者 = 506）。为了计算 PCSK-9 抑制剂的真实资格，开发了一种专有的可调软件，该软件存储数据和患者特征，并可以根据不同的标准确定资格。我们根据 ESC/EAS 2016 和 2019 指南、2017 美国心脏病学会专家共识和国家标准测试了四种不同 LDL 阈值的情景。结果合格率为18.85%，四种分类在总人群中的比例分别为 9.75%、8.55% 和 2.15%，并根据临床状况而有所不同。更新指南的增加主要归因于随着我们的标准变得更严格，越来越多的冠心病患者符合条件。结论首次通过可调整的预测模型在 2000 名患有急性冠状动脉综合征、慢性冠状动脉疾病和血脂异常的患者群体中提供了对 PCSK-9 资格的现实估计。这可能是将 PCSK-9 抑制剂纳入医疗保健系统的宝贵工具。更新指南的增加主要归因于随着我们的标准变得更严格，越来越多的冠心病患者符合条件。结论首次通过可调整的预测模型在 2000 名患有急性冠状动脉综合征、慢性冠状动脉疾病和血脂异常的患者群体中提供了对 PCSK-9 资格的现实估计。这可能是将 PCSK-9 抑制剂纳入医疗保健系统的宝贵工具。更新指南的增加主要归因于随着我们的标准变得更严格，越来越多的冠心病患者符合条件。结论首次通过可调整的预测模型在 2000 名患有急性冠状动脉综合征、慢性冠状动脉疾病和血脂异常的患者群体中提供了对 PCSK-9 资格的现实估计。这可能是将 PCSK-9 抑制剂纳入医疗保健系统的宝贵工具。