Expert Consensus on Clinical Application of PCSK 9 Inhibitors in Secondary Prevention of Ischemic Stroke (2026 Edition)

doi:10.3969/j.issn.1673-5765.2026.08.011

Abstract

Abstract: Lipid management is a cornerstone in the secondary prevention of ischemic stroke; however, the current rate of LDL-C target attainment among ischemic stroke patients in China remains suboptimal. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors provide a potent therapeutic option for intensive lipid lowering. The Chinese Stroke Association organized experts to develop the Expert Consensus on Clinical Application of PCSK9 Inhibitors in Secondary Prevention of Ischemic Stroke (2026 Edition), based on the 2019 edition and updated with the latest evidencebased data and clinical practice. This consensus provides a comprehensive update on the clinical use of PCSK9 inhibitors. It offers individualized recommendations for PCSK9 inhibitor use according to different risk stratifications of atherosclerotic cardiovascular disease (ASCVD), as well as for special populations, and emphasizes the importance of longterm standardized treatment and followup management. This consensus aims to provide evidencebased guidance for individualized lipid management and standardized use of PCSK9 inhibitors in the secondary prevention of ischemic stroke.

Key words: Proprotein convertase subtilisin/kexin type 9 inhibitor; Ischemic stroke; Secondary prevention; Low-density lipoprotein cholesterol; Lipid management; Atherosclerotic cardiovascular disease; Expert consensus

摘要： 血脂管理是缺血性卒中二级预防的关键环节，但目前我国缺血性卒中患者的LDL-C达标率仍不理想。前蛋白转化酶枯草溶菌素Kexin 9型（proprotein convertase subtilisin/kexin type 9，PCSK9）抑制剂为强化降脂治疗提供了新选择。中国卒中学会组织专家，在2019年发布的《前蛋白转化酶枯草溶菌素Kexin 9型抑制剂在缺血性卒中二级预防中的临床应用专家共识》基础上，基于最新循证证据与临床实践，形成了《前蛋白转化酶枯草溶菌素Kexin 9型抑制剂在缺血性卒中二级预防中的临床应用专家共识（2026版）》，对PCSK9抑制剂的临床应用推荐进行了全面更新。本共识针对不同危险分层及特殊人群进行了PCSK9抑制剂的个体化应用推荐，并强调长期规范治疗与随访管理的重要性。本共识旨在为缺血性卒中患者二级预防中的个体化血脂管理和PCSK9抑制剂规范应用提供循证依据与临床参考。

关键词: 前蛋白转化酶枯草溶菌素Kexin 9型抑制剂; 缺血性卒中; 二级预防; 低密度脂蛋白胆固醇; 血脂管理; 动脉粥样硬化性心血管疾病; 专家共识

CLC Number:

Chinese Stroke Association, Writing Group of the Expert Consensus on Clinical Application of PCSK9 Inhibitors in Secondary Prevention of Ischemic Stroke (2026 Edition). Expert Consensus on Clinical Application of PCSK 9 Inhibitors in Secondary Prevention of Ischemic Stroke (2026 Edition)[J]. Chinese Journal of Stroke, 2026, 21(8): 995-1007.

中国卒中学会, 《前蛋白转化酶枯草溶菌素Kexin 9型抑制剂在缺血性卒中二级预防中的临床应用专家共识（2026 版）》编写组. 前蛋白转化酶枯草溶菌素Kexin 9型抑制剂在缺血性卒中二级预防中的临床应用专家共识（2026版）[J]. 中国卒中杂志, 2026, 21(8): 995-1007.

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URL: https://www.chinastroke.org.cn/EN/10.3969/j.issn.1673-5765.2026.08.011

https://www.chinastroke.org.cn/EN/Y2026/V21/I8/995

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