Alirocumab treatment resulted in a similar reduction in plaque burden with a change in percentage atheroma volume of approximately −1.29% compared to placebo, showing no significant difference between end-diastolic and conventional 1-mm IVUS segmentation methods.
RCT (n=240)
Double-blind
Placebo-controlled randomization
Yes
Does end-diastolic IVUS segmentation provide different estimates of atheroma burden changes compared to conventional 1-mm segmentation in patients with acute myocardial infarction?
End-diastolic and conventional 1-mm IVUS segmentation approaches demonstrate comparable treatment effects of alirocumab on plaque regression, supporting the continued use of the less time-consuming 1-mm method in serial IVUS studies.
Effect estimate: Difference in change between alirocumab and placebo in TAV −14.64 mm3 vs. −14.34 mm3 (P=0.823), PAV −1.25% vs. −1.29% (P=0.911) (95% CI ICC for changes in TAV 0.84 (0.80–0.86) and PAV 0.66 (0.60–0.71) indicating good agreement)
Absolute Event Rate: -1.29% vs -1.25%
p-value: P=0.823 for TAV difference; P=0.911 for PAV difference
Background: This study compared changes in percentage atheroma volume (PAV) using an end-diastolic (ED) intravascular ultrasound (IVUS) segmentation approach vs. the conventional 1-mm interval analysis in serial IVUS data from the PACMAN-AMI trial.
Yap et al. (Tue,) conducted a rct in Patients admitted with acute myocardial infarction having 2 non-culprit vessels with non-flow limited disease (20%<diameter stenosis<50%) (n=240). Alirocumab plus high-intensity statin therapy vs. Placebo plus high-intensity statin therapy was evaluated on Change in percentage atheroma volume (PAV) and total atheroma volume (TAV) between baseline and 52-week follow-up measured by intravascular ultrasound (Difference in change between alirocumab and placebo in TAV −14.64 mm3 vs. −14.34 mm3 (P=0.823), PAV −1.25% vs. −1.29% (P=0.911), 95% CI ICC for changes in TAV 0.84 (0.80–0.86) and PAV 0.66 (0.60–0.71) indicating good agreement, p=P=0.823 for TAV difference; P=0.911 for PAV difference). Alirocumab treatment resulted in a similar reduction in plaque burden with a change in percentage atheroma volume of approximately −1.29% compared to placebo, showing no significant difference between end-diastolic and conventional 1-mm IVUS segmentation methods.