Effects of Evolocumab on Coronary Plaque Composition and Microcalcification Activity by Coronary Positron Emission Tomography (PET) and CT Angiography
Authors' conclusion
In stable patients with extensive noncalcified plaque volume at baseline, 18 months of evolocumab treatment was associated with a shift toward a lower risk quantitative plaque phenotype and reduction in microcalcification activity.
Study context
- Population
- Patients with extensive noncalcified plaque volume by coronary computed tomography angiography (CTA) (>440 µL overall or >250 µL in any single plaque)
- Participants
- 47 patients196 lesions
- Exposure
- Evolocumab: baseline vs 18-month follow-up
- Evolocumabn = 47
- Outcome
- Changes in coronary plaque composition on coronary CTA and coronary microcalcification on 18F-NaF PET
- Follow-up
- Mean 18 months
Methodological detailsopen-label
- Open-label
Main finding
As reported in the abstract
mean follow-up 18 months
- Total plaque volume: 716.2 ± 431.4 µL to 710.8 ± 456.2 µL, difference 5.4 ± 97.4 µL (no significant change)
- P = 0.705
- Noncalcified plaque: 607.3 ± 346.8 µL to 562.1 ± 337.3 µL, difference 45.2 ± 63.8 µL (significant reduction)
- P < 0.001
- Low-attenuation noncalcified plaque: 37.1 ± 28.9 µL to 20.4 ± 15.4 µL, difference 16.6 ± 23.5 µL (significant reduction)
- P < 0.001
- Calcified plaque: 108.9 ± 133.7 µL to 148.7 ± 175.3 µL, difference 39.8 ± 56.1 µL (increase)
- P < 0.001
- Coronary microcalcification activity: 1.35 ± 1.68 to 1.08 ± 1.37 (significant reduction)
- P = 0.004
- Lesion target-to-background ratio: 1.73 ± 0.85 to 1.62 ± 0.83 (significant reduction)
- P = 0.005
Observational data: associations, not effects.
Original publication
Effects of Evolocumab on Coronary Plaque Composition and Microcalcification Activity by Coronary PET and CT Angiography. JACC Cardiovasc Imaging. Published 2 April 2025. doi:10.
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