{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T05:14:02Z","timestamp":1778044442947,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aocs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lipids"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Ischemic stroke is frequently associated with symptomatic intracranial atherosclerotic stenosis (sICAS), is a leading cause of global disability and mortality. Current guidelines recommend dual antiplatelet and intensive statin therapies. Proprotein convertase subtilisin 9\/kexin type 9 (PCSK9) inhibitors have emerged as a potent lipid\u2010lowering therapy, potentially influenced by genetic variations, particularly in the\n                    <jats:italic>CYP2C19<\/jats:italic>\n                    gene. This study at Xuzhou Central Hospital from January 2021 to December 2023 included 151 patients divided into a statin group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200973) and a PCSK9 inhibitor (PCSK9i) group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200978). It evaluated lipid profiles, inflammatory markers, neurological function, and clinical outcomes over a 180\u2010day follow\u2010up period, with additional analysis stratified by CYP2C19 genotype. The PCSK9i group demonstrated significant improvements in lipid parameters compared to the statin group, including greater reductions in low\u2010density lipoprotein cholesterol (LDL\u2010C) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.008), total cholesterol (TC) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and triacylglycerols (TAG) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.041), along with apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Inflammatory markers, particularly interleukin\u20106 (IL\u20106), significantly reduced in the PCSK9i group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). In the PCSK9i group, CYP2C19 rapid metabolizers achieved greater reductions in LDL\u2010C (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.021), ApoB (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003), and IL\u20106 levels (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.041) compared to slow metabolizers. Post\u2010treatment modified Rankin Scale (mRS) scores were significantly lower in rapid metabolizers compared to slow metabolizers (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.018), though clinical events occurred infrequently in both subgroups. This study demonstrates that PCSK9 inhibitor therapy combined with statins provides enhanced lipid\u2010lowering and anti\u2010inflammatory effects compared to statin monotherapy in sICAS patients. While the CYP2C19 genotype may influence specific treatment responses, particularly lipid parameters, its impact on clinical outcomes requires further investigation.\n                  <\/jats:p>","DOI":"10.1002\/lipd.70018","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T03:44:12Z","timestamp":1766375052000},"page":"319-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of\n                    <i>CYP2C19<\/i>\n                    Genotype Variants on\n                    <scp>PCSK9<\/scp>\n                    Inhibitor Efficacy in Lipid\u2010Lowering Among Patients With Symptomatic Intracranial Atherosclerotic Stenosis"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5324-6029","authenticated-orcid":false,"given":"Chao","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Neurology Suzhou Medical College of Soochow University  Suzhou China"},{"name":"Department of Neurology The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University  Xuzhou China"},{"name":"Xuzhou First People's Hospital  Xuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University  Xuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Di","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neurology The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University  Xuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurology The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University  Xuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University  Xuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guofang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology Suzhou Medical College of Soochow University  Suzhou China"},{"name":"Department of Neurology Xuzhou Central Hospital  Xuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2022.101342"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.26355\/eurrev_202011_23618"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.667234"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2023.175672"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060520934657"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.117.017866"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.70328"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.2133\/dmpk.dmpk\u201013\u2010rg\u2010137"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.1016126"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1472\u20108206.2004.00292.x"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2020.173114"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872\u2010025\u201004768\u20108"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S489235"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009\u20109236(03)00121\u20108"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.4155\/fmc\u20102018\u20100294"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2023.1242711"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.121.319947"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/atv.0000000000000073"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.45578"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2020.1731678"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.2217\/pme\u20102022\u20100041"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ\u201018\u20101386"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/prp2.775"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13072\u2010020\u201000366\u20104"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chemosphere.2018.07.181"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2021.1915799"}],"container-title":["Lipids"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aocs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lipd.70018","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aocs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lipd.70018","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aocs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lipd.70018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T04:46:24Z","timestamp":1778042784000},"score":1,"resource":{"primary":{"URL":"https:\/\/aocs.onlinelibrary.wiley.com\/doi\/10.1002\/lipd.70018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,21]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/lipd.70018"],"URL":"https:\/\/doi.org\/10.1002\/lipd.70018","archive":["Portico"],"relation":{},"ISSN":["0024-4201","1558-9307"],"issn-type":[{"value":"0024-4201","type":"print"},{"value":"1558-9307","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,21]]},"assertion":[{"value":"2024-11-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}