Key result
Alirocumab added to high-intensity statins enhances coronary plaque regression and lipid burden reduction post-AMI.
Why the study?
The mechanisms underlying the greater cardiovascular benefit of PCSK9 inhibition with alirocumab among patients at high atherothrombotic risk remain largely unknown.
Does alirocumab added to high-intensity statin improve coronary plaque regression in AMI patients stratified by atherothrombotic risk?
RCT (n=263)
double-blind
randomized
Does alirocumab added to high-intensity statin improve coronary plaque regression in AMI patients stratified by atherothrombotic risk?
Mean Difference: -1.8 (95% CI -2.5–-1)
p-value: p=<0.001
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In AMI patients, the addition of alirocumab to high-intensity statin therapy resulted in greater coronary plaque regression and lipid burden reduction in patients not at very-high atherothrombotic risk.
Ueki et al. (2025) conducted an RCT in acute myocardial infarction (AMI) (n=263). alirocumab vs. placebo in addition to high-intensity statin was evaluated on percent atheroma volume (PAV) by IVUS (MD -1.8%, 95% CI -2.5 to -1.0, p=<0.001). Alirocumab added to high-intensity statins resulted in greater coronary plaque regression in non-very-high risk AMI patients (PAV difference -1.8%) than in very-high risk patients (-0.8%).
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