Efficacy and Safety of PCSK9 Inhibitors in Patients With Large-Artery Atherosclerosis (LAA) Ischemic Stroke: A Prospective Multicenter Cohort Study
This prospective multicenter cohort study aims to evaluate the effectiveness and safety of early PCSK9 inhibitor therapy in patients with large-artery atherosclerotic ischemic stroke. The study will compare early neurological improvement, lipid-lowering effect, 90-day functional outcome, recurrent cardio-cerebrovascular events, and safety outcomes between patients treated with evolocumab plus statin and those treated with statin alone.
• Age 18-80 years.
• Acute ischemic stroke diagnosed according to the Chinese Guidelines for Diagnosis and Treatment of Acute Ischemic Stroke (2023), based on clinical and imaging criteria.
• Large-artery atherosclerotic subtype (TOAST classification) confirmed within 72 hours after stroke onset.
• NIHSS score 4-20 before treatment.
• Pre-stroke modified Rankin Scale (mRS) score ≤1.
• LDL-C ≥1.8 mmol/L before enrollment.
• Able to use evolocumab and statin medications in accordance with the physician's instructions and the prescribing information.
• No prior use of a PCSK9 inhibitor before enrollment.
• Written informed consent provided by the participant or legally authorized representative.