Prevention & lipidsMechanistic study
Intracoronary Imaging and Transcriptomic Characteristics Before and After Maximum Lipid-Lowering Therapy
- Mechanistic study
- single-arm
- serial intracoronary imaging
Authors' conclusion
In stable coronary artery disease, intravascular imaging-verified beneficial changes in plaque morphology after evolocumab treatment were associated with restored mitochondrial function, suppressed inflammation, and alleviated oxidative stress.
Study context
- Population
- Stable CAD patients receiving maximally tolerated statin therapy; nonobstructive lesions
- Participants
- 110 patients
- Comparison
- Before vs after evolocumab added to maximum statin therapy
Main finding
As reported in the abstract
OCT fibrous cap thickness (FCT) increased from 70.9 ± 21.7 to 97.7 ± 31.1 μm
mean 26.8 ± 22.3 μm; P < 0.001
Maximal lipid core burden index within 4 mm (LCBI) decreased from 306.8 ± 177.6 to 213.1 ± 168.0
mean −93.7 ± 140.5; P < 0.001
Percentage atheroma volume (intravascular ultrasound) significantly reduced
−1.38% ± 1.48%; P < 0.001
Further findings
PBMC transcriptomics · follow-up
- Up-regulated differentially expressed genes
- 922
- Down-regulated differentially expressed genes
- 571
- Immune cell adhesion, recruitment and communication pathways down-regulated; mitochondrial function, cell survival and protein synthesis pathways up-regulated
Prediction of response from baseline genes (elastic net)
- FCT increase, 38 genes, AUC
- 0.97
- LCBI reduction, 71 genes, AUC
- 0.86
Original publication
Summarised from the published abstract; every number is checked against it