VICTORION-INCEPTION Study

The discussion centers around the promising role of PCSK9 inhibitors in reducing plaque vulnerability and volume, especially when introduced early in patient care. Clinicians are increasingly interested in the potential cardiovascular benefits of using these inhibitors soon after acute coronary events. This approach could not only lower low-density lipoprotein (LDL) cholesterol more rapidly but also potentially lead to better clinical outcomes by targeting the critical early post-event period when patients face the highest risk for further complications.

The VICTORION-INCEPTION study, led by researchers including Knowlton and Brown, was designed to explore whether early intervention with PCSK9 inhibitors—specifically, inclisiran—could significantly improve LDL target attainment following acute coronary syndrome. Administered in a pragmatic setting, inclisiran was introduced within 5 weeks of a cardiac event in patients who failed to meet LDL targets despite maximum statin therapy. The study showed that early administration led to a higher percentage of patients achieving LDL levels under 70 mg/dL and even under 55 mg/dL, compared with usual care alone.

These findings are bolstered by retrospective meta-analyses indicating that earlier lipid-lowering treatment is linked to reduced cardiovascular event rates. While more prospective research is needed, the convenience of administering inclisiran—just 2 doses in the first 3 months and then every 6 months thereafter—may help overcome adherence barriers and enable more effective post-discharge care. Overall, this strategy holds promise for improving long-term cardiovascular outcomes by optimizing LDL control in a vulnerable patient population.