PCSK9 Inhibitors and Risk of Aortic Stenosis in Atherosclerotic Cardiovascular Disease
Main finding · New-onset ASResult — go to the resultHazard ratio 0.87 95% CI 0.78–0.97Authors' conclusion
In statin-treated patients with ASCVD, PCSK9i use was associated with a modestly lower 5-year incidence of new-onset AS. Large mortality and HFE associations may reflect residual confounding and treatment-selection bias. These findings are hypothesis-generating.
Study context
- Population
- Adults aged ≥60 years with atherosclerotic cardiovascular disease (ASCVD) receiving statins from January 1, 2015, to August 31, 2025patients in each group after 1:1 matching
- Participants
- 22,924 adults
- Exposure
- PCSK9is were compared with statin-only users after 1:1 propensity score matching
- PCSK9isn = 22,924
- Statin-only usersn = 22,924reference
- Outcome
- New-onset aortic stenosis (AS)
- Follow-up
- Within 5 years
Methodological details1:1 propensity score matching, TriNetX
- 1:1 propensity score matching
- TriNetX
Main finding
As reported in the abstract
Hazard ratio
0.87
95% CI 0.78–0.97
P = 0.012
PCSK9isvs statin-only users
HR 0.87 (95% CI 0.78–0.97); P = 0.012
Observational data: associations, not effects.
Secondary outcomes
All-cause mortality and heart failure exacerbation (HFE)
- PCSK9is use was associated with a lower risk of all-cause mortality and HFE
Aortic valve replacement
- Aortic valve replacement reduction was not significant
Subgroup analyses
- Statistically significant interaction was observed only for chronic kidney disease and heart failure
Original publication
PCSK9 Inhibitors and Risk of Aortic Stenosis in Atherosclerotic Cardiovascular Disease. JACC Adv. Published 11 September 2026. doi:10.
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