Add-On PCSK9 Inhibitor Therapy for Acute Stroke Attributable to Intracranial Atherosclerosis: A Randomized Clinical Trial.
J Am Heart AssocSep 9, 2026 (epub)
Yi-Ting Pan, Yuan-Hsiung Tsai, Hsu-Huei Weng et al.
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In 30 seconds
This randomized controlled trial evaluated the efficacy of add-on PCSK9 inhibitor therapy in 62 patients with symptomatic intracranial atherosclerotic stenosis. Results showed a significant reduction in intracranial artery stenosis in the PCSK9 inhibitor group (7.1%) compared to controls (-1.2%) at 6 months (P <0.001), alongside improved LDL cholesterol control.
Key findings
- Median stenosis reduction was 7.1% in the PCSK9i group versus -1.2% in controls (P <0.001).
- 85% of the PCSK9i group achieved LDL cholesterol <55 mg/dL compared to 13% of controls (P <0.01).
- Recurrent stroke occurred in 5% of the PCSK9i group versus 13% of controls (P =0.34).
Why it matters
The study highlights the potential of PCSK9 inhibitors as an adjunctive therapy for patients with intracranial atherosclerotic stenosis, addressing a significant cause of ischemic stroke and its high recurrence rates.