Coronary disease & ACSCohort study
Achieved low-density lipoprotein cholesterol (LDL-C) levels <55 mg/dL and cardiac events in patients and lesions harbouring lipid-rich plaque phenotypes
- multi-centre registry
Authors' conclusion
NIRS-derived lipid-rich plaque may be a potential imaging measure reflecting patients and lesions that may benefit from achieving LDL-C levels < 55 mg/dL.
Study context
- Population
- Coronary artery disease patients receiving NIRS/IVUS-guided PCIcoronary artery disease patients, non-culprit lesions = 1662
- Participants
- 853 patients
- Exposure
- on-treatment LDL-C < 55 mg/dL vs on-treatment LDL-C ≥55 mg/dL
Main finding
MACE, patients with maxLCBI4mm < 324.7 · median = 1109 days
Adjusted hazard ratio
1.42
95% CI 0.80–2.54
P = 0.227
on-treatment LDL-C < 55 mg/dL vs on-treatment LDL-C ≥55 mg/dL
adjusted HR 1.42 (95% CI 0.80–2.54); P = 0.227
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| MACE, patients with non-culprit lesion maxLCBI4mm ≥ 324.7 · median = 1109 days | 0.23 (0.09–0.57) | P = 0.010 | |
| MACE, lesion-based analysis — on-treatment LDL-C < 55 mg/dL vs on-treatment LDL-C ≥55 mg/dL · non-culprit lesion maxLCBI4mm < 324.7 | 1.30 (0.42–4.00) | P = 0.640 | |
| MACE, lesion-based analysis — on-treatment LDL-C < 55 mg/dL vs on-treatment LDL-C ≥55 mg/dL · non-culprit lesion maxLCBI4mm ≥ 324.7 | 0.27 (0.08–0.97) | P = 0.045 | |
| MACE, by number of non-culprit lesions with maxLCBI4mm ≥ 324.7 — on-treatment LDL-C < 55 mg/dL vs on-treatment LDL-C ≥55 mg/dL | 0.22 (0.09–0.53) | P < 0.001 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
| Outcome | adjusted HR (95% CI) | P value |
|---|---|---|
| MACE, by number of non-culprit lesions with maxLCBI4mm ≥ 324.7 — on-treatment LDL-C < 55 mg/dL vs on-treatment LDL-C ≥55 mg/dL | 0.03 (0.00–5.55) | P = 0.196 |
- Major adverse cardiac events (MACE), patients with non-culprit lesion maxLCBI4mm ≥ 324.7: significantly reduced MACE rate with on-treatment LDL-C < 55 mg/dL
- MACE, by number of non-culprit lesions with maxLCBI4mm ≥ 324.7: multiple non-culprit lesions with maxLCBI4mm ≥ 324.7; lower frequency of MACE
- MACE, by number of non-culprit lesions with maxLCBI4mm ≥ 324.7: single non-culprit lesion with maxLCBI4mm ≥ 324.7; relationship not observed
Achievement of on-treatment LDL-C < 55 mg/dL · 3 months after PCI
- study subjects achieved on-treatment LDL-C < 55 mg/dL
- 31.6%
Original publication
Achieved LDL-C levels &lt;55 mg/dL and cardiac events in patients and lesions harbouring lipid-rich plaque phenotypes. Eur Heart J Cardiovasc Imaging. Published 25 February 2026. doi:10.1093/ehjci/jeag057
Summarised from the published abstract; every number is checked against it