{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:47:32Z","timestamp":1782276452367,"version":"3.54.5"},"reference-count":41,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Early initiation of proprotein convertase subtilisin\/kexin type 9 inhibitors (PCSK9-i) in patients with acute myocardial infarction (MI) may anticipate and maximize lipid-lowering benefit. Whether PCSK9 inhibition also exerts early anti-inflammatory effects in this setting remains unclear. This study aimed to evaluate the effects of early PCSK9-i administration on inflammatory markers and lipid parameters in patients with acute MI undergoing percutaneous coronary intervention (PCI). Methods: In this randomized, prospective, single-center, open-label trial, patients with acute MI undergoing PCI were randomly assigned to receive a single upstream 140 mg subcutaneous dose of evolocumab immediately before PCI, on top of oral lipid-lowering therapy (LLT) (n = 30), or oral LLT alone (control group; n = 30). Tumor necrosis factor-alpha (TNF-\u03b1), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB), and lipoprotein(a) [Lp(a)] levels were measured at baseline and during the early post-intervention phase. Results: Baseline TNF-\u03b1 values and lipid parameters were similar between the two groups. At 72 h after PCI, TNF-\u03b1 levels were significantly lower in the evolocumab arm compared with controls (0.01 vs. 0.25 pg\/mL; p = 0.025). Evolocumab was also associated with a greater relative reduction in LDL-C levels from baseline (\u221248% vs. \u221218%; p &lt; 0.001) and apoB levels (\u221234% vs. \u221211%; p &lt; 0.001). The proportion of patients achieving the LDL-C goal of &lt;55 mg\/dL at 72 h was higher in the evolocumab group than in controls (50% vs. 10%; p &lt; 0.001). Lp(a) levels at 72 h were also lower with evolocumab (12 [10\u201333] vs. 28 [13.1\u201370] mg\/dL; p = 0.032). Conclusions: In patients with acute MI undergoing PCI, upstream administration of a single evolocumab dose was associated with suppression of the early post-intervention increase in TNF-\u03b1 levels, together with rapid reductions in LDL-C, apoB, and Lp(a). These findings suggest a potential modulation of the early inflammatory response by PCSK9 inhibition in addition to its lipid-lowering effects. Larger studies are needed to confirm these observations and to determine their clinical relevance.<\/jats:p>","DOI":"10.3390\/jcm15134873","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:09:17Z","timestamp":1782270557000},"page":"4873","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Suppression of Early TNF-Alpha Increase by a Single Evolocumab Dose in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5404-3968","authenticated-orcid":false,"given":"Giuseppe","family":"Patti","sequence":"first","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy"},{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Bosco","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0797-3636","authenticated-orcid":false,"given":"Alessandra","family":"Marengo","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-4016","authenticated-orcid":false,"given":"Luca","family":"Cumitini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5277-9907","authenticated-orcid":false,"given":"Leonardo","family":"Grisafi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"D\u2019Amario","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy"},{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Solli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3795-8787","authenticated-orcid":false,"given":"Marco","family":"Mennuni","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy"},{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"2021 ESC Guidelines on cardiovascular disease prevention in clinical practice","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur. 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