Serial Changes in Coronary Plaque Formation Using CT Angiography in Patients Undergoing PCSK9-Inhibitor Therapy With 1-year Follow-up.
Journal
Journal of thoracic imaging
ISSN: 1536-0237
Titre abrégé: J Thorac Imaging
Pays: United States
ID NLM: 8606160
Informations de publication
Date de publication:
01 Sep 2022
01 Sep 2022
Historique:
pubmed:
8
7
2022
medline:
25
8
2022
entrez:
7
7
2022
Statut:
ppublish
Résumé
Previous studies have shown positive effects of intensive low-density lipoprotein (LDL)-lowering therapy on atheroma volume using invasive intravascular ultrasound. This study describes the changes in coronary plaque composition on coronary computed tomography angiography in patients treated with proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors. In this prospective study, coronary plaques were analyzed using third-generation dual-source computed tomography before and after 1 year of PCSK9-inhibitor treatment. Plaque markers included total plaque volume (TPV), calcified plaque volume (CPV), noncalcified plaque volume (NCPV), lumen volume and vessel volume (VV), minimal luminal area (MLA), minimal lumen diameter (MLD), corrected coronary opacification, eccentricity, remodeling index, and functional plaque parameters. Primary endpoint was defined as change in TPV; the secondary endpoint was TPV or CPV regression or nominal change in plaque parameters. We analyzed 74 coronary plaques in 23 patients (60±9 y, 65% male). After 1 year of PCSK9-inhibitor treatment, LDL was reduced from 148 to 66 mg/dL ( P <0.0001). Significant changes were found for VV (196 to 215 mm 3 , P =0.0340), MLA (3.1 to 2.6 mm 2 , P =0.0413), and MLD (1.7 to 1.4 mm, P =0.0048). TPV, CPV, NCPV, lumen volume, and functional plaque parameters did not change significantly ( P >0.05). Coronary artery plaque analysis by coronary computed tomography angiography highlights that LDL lowering therapy affects plaque composition. The primary endpoint of TPV change was not reached; however, VV, MLA, and MLD changed significantly.
Identifiants
pubmed: 35797638
doi: 10.1097/RTI.0000000000000666
pii: 00005382-202209000-00003
doi:
Substances chimiques
PCSK9 protein, human
EC 3.4.21.-
Proprotein Convertase 9
EC 3.4.21.-
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
285-291Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
U.J.S. received research support from and/or is a consultant for Bayer, Bracco, Elucid BioImaging, HeartFlow Inc., GE, Guerbet, Keya Medical, and Siemens. S.B. received consulting fees from Phillips Volcano and C.T. received research support and honoraria for speaking from Siemens. M.R. received speaker fees from Abbott. The remaining authors declare no conflict of interest.
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