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Effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography
BACKGROUND: Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors have been demonstrated to produce significantly greater reduction in LDL cholesterol levels and cardiovascular events than standard statin therapy. However, evidence on the impact of PCSK9 inhibitors on coronary plaque comp...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436513/ https://www.ncbi.nlm.nih.gov/pubmed/34511134 http://dx.doi.org/10.1186/s12944-021-01528-3 |
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author | Gao, Fei Wang, Zhi Jian Ma, Xiao Teng Shen, Hua Yang, Li Xia Zhou, Yu Jie |
author_facet | Gao, Fei Wang, Zhi Jian Ma, Xiao Teng Shen, Hua Yang, Li Xia Zhou, Yu Jie |
author_sort | Gao, Fei |
collection | PubMed |
description | BACKGROUND: Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors have been demonstrated to produce significantly greater reduction in LDL cholesterol levels and cardiovascular events than standard statin therapy. However, evidence on the impact of PCSK9 inhibitors on coronary plaque composition and morphology is limited. METHODS: In this open-label randomized study, eligible patients with intermediate coronary lesions and elevated LDL cholesterol values were randomized to either alirocumab 75 mg Q2W plus statin (atorvastatin 20 mg/day or rosuvastatin 10 mg/day) therapy or standard care. Optical coherence tomography (OCT) assessments for target lesions were obtained at baseline and at 36 weeks of follow-up. RESULTS: LDL cholesterol levels were significantly decreased in both the alirocumab and standard care arms, whereas the absolute reduction in LDL cholesterol was significantly greater in patients treated with alirocumab (1.72 ± 0.51 vs. 0.96 ± 0.59, P < 0.0001). Compared with standard care, the addition of alirocumab to statins was associated with significantly greater increases in minimum fibrous cap thickness (18.0 [10.8–29.2] μm vs 13.2 [7.4–18.6] μm; P = 0.029), greater increases in minimum lumen area (0.20[0.10–0.33] mm(2) vs 0.13 [0.12–0.24] mm(2); P = 0.006) and a greater diminution in maximum lipid arc (15.1̊ [7.8–24.5] vs. 8.4̊ [2.0–10.5]; P = 0.008). CONCLUSIONS: The addition of alirocumab to statins can not only provide additional LDL cholesterol lowering effects but also have a potential role in promoting a more stable plaque phenotype. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04851769. Registered 2 Mar 2019. |
format | Online Article Text |
id | pubmed-8436513 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-84365132021-09-13 Effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography Gao, Fei Wang, Zhi Jian Ma, Xiao Teng Shen, Hua Yang, Li Xia Zhou, Yu Jie Lipids Health Dis Research BACKGROUND: Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors have been demonstrated to produce significantly greater reduction in LDL cholesterol levels and cardiovascular events than standard statin therapy. However, evidence on the impact of PCSK9 inhibitors on coronary plaque composition and morphology is limited. METHODS: In this open-label randomized study, eligible patients with intermediate coronary lesions and elevated LDL cholesterol values were randomized to either alirocumab 75 mg Q2W plus statin (atorvastatin 20 mg/day or rosuvastatin 10 mg/day) therapy or standard care. Optical coherence tomography (OCT) assessments for target lesions were obtained at baseline and at 36 weeks of follow-up. RESULTS: LDL cholesterol levels were significantly decreased in both the alirocumab and standard care arms, whereas the absolute reduction in LDL cholesterol was significantly greater in patients treated with alirocumab (1.72 ± 0.51 vs. 0.96 ± 0.59, P < 0.0001). Compared with standard care, the addition of alirocumab to statins was associated with significantly greater increases in minimum fibrous cap thickness (18.0 [10.8–29.2] μm vs 13.2 [7.4–18.6] μm; P = 0.029), greater increases in minimum lumen area (0.20[0.10–0.33] mm(2) vs 0.13 [0.12–0.24] mm(2); P = 0.006) and a greater diminution in maximum lipid arc (15.1̊ [7.8–24.5] vs. 8.4̊ [2.0–10.5]; P = 0.008). CONCLUSIONS: The addition of alirocumab to statins can not only provide additional LDL cholesterol lowering effects but also have a potential role in promoting a more stable plaque phenotype. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04851769. Registered 2 Mar 2019. BioMed Central 2021-09-12 /pmc/articles/PMC8436513/ /pubmed/34511134 http://dx.doi.org/10.1186/s12944-021-01528-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Gao, Fei Wang, Zhi Jian Ma, Xiao Teng Shen, Hua Yang, Li Xia Zhou, Yu Jie Effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography |
title | Effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography |
title_full | Effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography |
title_fullStr | Effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography |
title_full_unstemmed | Effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography |
title_short | Effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography |
title_sort | effect of alirocumab on coronary plaque in patients with coronary artery disease assessed by optical coherence tomography |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436513/ https://www.ncbi.nlm.nih.gov/pubmed/34511134 http://dx.doi.org/10.1186/s12944-021-01528-3 |
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