ESC Congress 2026 Abstract · Oct 26, 2026

Treatment with PCSK9 inhibitors reduces the expression of scavenger receptors CD16, CD36 and CD45 in patients with stable coronary artery disease and elevated Lp(a) levels

By Ugovsek S, Rehberger Likozar A, Levstek T et al.

Background: Atherosclerosis is a chronic inflammatory disease driven by dyslipidemia and activation of immune system. Scavenger receptors CD16+, CD36+ and CD45+ on peripheral blood mononuclear cells (PBMCs) are involved in foam cell formation and endothelial dysfunction, promoting atherosclerosis. Although protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (PCSK9i) effectively lower lipid concentration and reduce cardiovascular events, their impact on above mentioned scavenger receptors remains poorly understood. Purpose: We aimed to examine the impact of PCSK9i treatment on the expression of scavender receptors CD16+, CD36+ and CD45+ on PBMC, and their association with lipoprotein levels in patients with stable coronary disease and significantly elevated lipoprotein (a) (Lp(a)) levels. Methods: In randomized, double-blind, placebo-controlled trial we included 100 statin-treated patients in stable phase after myocardial infarction elevated Lp(a) values. The patients received PCSK9i or placebo every two weeks for 6 months. Biochemical and cell analysis at baseline and after 6 months were performed. Results: Treatment with PCSK9i significantly decreased concentration of PBMCs expressing CD16+ and CD45+ (p=0.046 and p<0.001, respectively), and non-classical monocytes (NCM) expressing CD36+ (p=0.019), while no differences were observed among classical (CM) or intermediate monocytes (IM) expressing CD36+, neither in the placebo group. After treatment with PCSK9i, expression of IM CD36+ was associated with changes in Lp(a) (ρ=-0.276, p=0.029), total cholesterol (ρ=-0.306, p=0.014), low-density lipoprotein cholesterol (ρ=-0.276, p=0.027) and apolipoprotein B (ρ=-0.400, p=0.001). Additionally, expression of NCM CD36+ was associated with changes in Lp(a) (ρ=-0.252, p=0.046). No significant associations were observed between lipid parameters and monocyte subsets in the placebo group. Conclusion: In patients with stable coronary disease and elevated Lp(a) levels, treatment with PCSK9i significantly decreases expression of scavenger receptors CD16+, CD36+ and CD45+ on PBMCs.

doi.org/10.1093/eurheartj/ehag785.4134Open accessInterventions