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Clin Investig Arterioscler. 2019 May - Jun;31(3):128-139. doi: 10.1016/j.arteri.2019.04.002. Epub 2019 May 24.

Indications of PCSK9 inhibitors in clinical practice. Recommendations of the Spanish Sociey of Arteriosclerosis (SEA), 2019.

[Article in English, Spanish]

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Hospital Clínico, Universidad de Valencia, CIBERDEM, Valencia, España.
Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España.
Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBEROBN, Córdoba, España.
Hospital Universitario de Reus, Universidad Rovira y Virgili, IISPV, CIBERDEM, Reus, Tarragona, España.
Hospital Carlos III, Madrid, España.
Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España.
Hospital Universitario de Bellvitge-Idibell, Universidad de Barcelona, CIBEROBN, Hospitalet de Llobregat, Barcelona, España. Electronic address:
Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España.


A group of experts convened by the Spanish Society of Arteriosclerosis (SEA) has been in charge of updating the SEA document on the indications of PCSK9 inhibitors (PCSK9i) in clinical practice that was published in 2016. This update is justified by the fact that the data from clinical trials carried out on a large scale with PCSK9i have shown that in addition to their high potency to lower atherogenic cholesterol, they reduce the risk of atherosclerotic cardiovascular disease, both in patients with stable disease, and with recent disease, and with a high degree of security. This update provides the recommendations and level of evidence for the prescription of iPCSK9 in patients with homozygous and heterozygous familial hypercholesterolemia, with atherosclerotic cardiovascular disease, and in primary prevention in patients with very high cardiovascular risk. These recommendations have been established taking into account the concentration of LDL-C, the clinical situation of the patient, the additional risk factors and the cost-effectiveness of their use.


Cardiovascular disease; Clinical indications; Colesterol; Consensus document; Documento de consenso; Enfermedad cardiovascular; Familial hypercholesterolemia; Hipercolesterolemia familiar; Indicaciones clínicas; Inhibidores de la proproteína convertasa subtilisina kexina 9; Lipoproteínas de baja densidad; Low density lipoprotein; Number needed to treat; Número necesario a tratar; Proprotein convertase subtilisin kexin 9 inhibitors; Tratamiento; Treatment

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