The primary goal is to assess the impact of Evolocumab therapy on platelet function of familial hypercholesterolemia (FH) patients in a randomized, double blind study. Evolocumab is a humanized monoclonal antibody that targets circulating PCSK9, increases hepatic LDL receptor, decreases plasma LDL cholesterol and reduces risk of cardiovascular events. Evolocumab (brand name Rapatha) has been approved by FDA along with diet and maximally tolerated statin therapy in adults with FH or atherosclerotic heart or blood vessel problems, who need additional lowering of LDL cholesterol. The secondary goal is to determine if platelet activation or the response to Evolocumab therapy is modified by rs3184504 polymorphism. The investigators believe that these investigations will complement ongoing studies to demonstrate that Evolocumab reduces athero-thrombotic risk and aid the decision-making as to whether Evolocumab can reduce the atherothrombotic risk in ACS patients.
Name: EvolocumabDescription: 140 mg every 14 days A monoclonal antibody designed for the treatment of hyperlipidemiaType: Drug
Description: ADP-stimulated platelet aggregation as assessed by the commercially-available VerifyNow P2Y12 assay (Accriva Diagnostics) will be performed. Unit: PRU.Measure: Change in P2Y12 Reaction Units Time: Day 7, Day 14, Day 21, Day 28, Day 84, Day 196.
Description: Platelet activation measured by flow cytometry or commercially-available enzyme-linked immunoassays (ELISAs). Reported as % positive cells (out of 50,000 cells counted) showed a mean reduction ± standard deviation (SD)Measure: Change in platelet P-selectin level Time: Day 7, Day 14, Day 21, Day 28, Day 84, Day 196
There is one SNP
The secondary goal is to determine if platelet activation or the response to Evolocumab therapy is modified by rs3184504 polymorphism.