Abstract
This study investigated the effects of evolocumab on vulnerable coronary plaques and factors associated with the change in stability and size of plaques in patients taking statins. Vulnerable coronary plaques were defined using coronary computed tomography (CT) angiography as having a density of <50 HU within the region of interest and a remodeling index ≥1.1. The changes in minimum CT density, remodeling index, and percent stenosis of vulnerable coronary plaques after six months of evolocumab administration were retrospectively analyzed in 136 vulnerable coronary plaques from 98 patients (68 men and 30 women; mean age: 72.9 ± 8.7 years) treated with a statin. The administration of evolocumab significantly increased the minimum CT density (39.1 ± 8.1 HU to 84.9 ± 31.4 HU, p < 0.001), reduced the remodeling index (1.29 ± 0.11 to 1.19 ± 0.10, p < 0.001), and decreased the percent stenosis (27.0 ± 10.4% to 21.2 ± 9.8%, p < 0.001). Multiple linear regression analysis revealed that baseline percent stenosis (standard coefficient (β) = −0.391, p = 0.002) independently correlated with the change in minimum CT density, whereas the baseline remodeling index (β = −0.368, p < 0.001) independently correlated with a change in the remodeling index. Evolocumab stabilized vulnerable coronary plaques and reduced their size. These results suggest that evolocumab protects against coronary artery disease progression in patients taking statins.
Highlights
Coronary artery disease is a major cause of death worldwide [1]
We investigated the effects of evolocumab on vulnerable coronary plaques assessed using computed tomography (CT) angiography and the factors associated with the change in stability and size of vulnerable coronary plaques
We found that evolocumab increased the stability, reduced the size of vulnerable coronary plaques, and decreased the percent stenosis at vulnerable coronary plaque sites in patients taking statins
Summary
The majority of coronary artery disease cases can be attributed to the progression and/or rupture of vulnerable plaques [2]. A recent study has showed that the presence of vulnerable plaques and their progression are independent predictors for the development of acute coronary syndrome [3]. The stabilization and regression of vulnerable coronary plaques are important for the prevention of acute coronary syndrome, myocardial infarction, and sudden cardiac death. Coronary computed tomography (CT) angiography has recently emerged as a noninvasive imaging modality for the assessment of coronary plaques. It has high spatial resolution, permitting the visualization of a number of components of the vulnerable plaque. The evaluation of coronary plaques using coronary CT angiography is a less invasive method and is repeatable and reliable
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
