Coronary disease & ACSCohort study
Effects of Evolocumab on Coronary Plaque Composition and Microcalcification Activity by Coronary Positron Emission Tomography (PET) and CT Angiography
- Prospective single-arm imaging study
- open-label
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 patients · 196 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
Main finding
As reported in the abstract
Coronary plaque volumes (CTA) and microcalcification activity (18F-NaF PET), baseline to follow-up · 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:10.1016/j.jcmg.2025.01.005
Summarised from the published abstract; every number is checked against it