Objective  To systematically evaluate the efficacy and safety of alirocumab after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.

Methods  CNKI, WanFang Data, VIP, PubMed, Embase, Web of Science, and The Cochrane Library were comprehensively searched from the inception of the databases to May 31, 2024. RevMan 5.4 software was used to perform a Meta-analysis.

Results  A total of 13 randomized controlled trials (RCTs) with a cumulative total of 1 217 patients were included. On the basis of conventional treatment, the experimental group was treated with alirocumab in combination with statin, and the control group was treated with statin only. Meta-analysis results showed that compared with the control group, the efficiency of clinical treatment [OR=4.71, 95%CI (2.49, 8.94), P<0.001], rate of blood lipid compliance [OR=29.87, 95%CI (12.45, 71.68), P<0.001], coronary blood flow grading [OR=2.73, 95%CI (1.74, 4.30), P<0.001], left ventricular ejection fraction [MD=7.31, 95%CI (4.47, 10.15), P<0.001] in the experimental group were all improved, and the incidence of adverse cardiovascular events [OR=0.16, 95%CI (0.09, 0.29), P<0.001], low-density lipoprotein [MD=-1.00, 95%CI (-1.34, -0.67), P<0.001], triglyceride [MD=-0.22, 95%CI (-0.34, -0.10), P<0.001], total cholesterol [MD=-0.89, 95%CI (-1.19, -0.59), P<0.001], interleukin-6 [MD=-3.58, 95%CI (-5.03, -2.14), P<0.001] decreased. There was no statistically significant difference between the two groups in the reduction of high-sensitivity C-reactive protein [MD=- 0.89, 95%CI (-2.24, -0.46), P=0.20] and the incidence of adverse drug reactions [OR=0.77, 95%CI (0.32, 1.85), P=0.56].

Conclusion  Combinated alirocumab injection therapy after PCI for acute myocardial infarction has superior clinical efficacy, and there was no significant difference in the reduction of high-sensitivity C-reactive protein and incidence of adverse drug reactions compared with statins alone.

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