Effect of Evolocumab on Vulnerable Coronary Plaques: A Serial Coronary Computed Tomography Angiography Study

Figures

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  Figure 1. Study design. Abbreviations: CT, computed tomography; HDL, high-density lipoprotein; IMT, intima–media thickness; LDL, low-density lipoprotein.

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  Figure 2. CT angiography imaging of the coronary artery. Several circular regions of interest (with areas of 1 mm2) were placed in the coronary plaque (A). Tissue with a CT density < 0 HU was considered pericardial fat surrounding the vessel and excluded from the analysis. The minimum CT density of the plaque was determined by comparing the mean CT density of each circular region of interest. In this case, the mean CT density of each circular region of interest was 76, 83, 35, and 76 HU; therefore, the minimum CT density of the plaque was 35 HU (A). The remodeling index was calculated by dividing the maximum vessel diameter in the lesion by the mean of the proximal and distal reference vessel diameters (B). In this case, the maximum vessel diameter in the lesion, the proximal reference vessel diameter, and the distal reference vessel diameter were 4.70, 4.02, and 4.08, respectively; therefore, the remodeling index was 1.16 (B). The percent stenosis was calculated as a ratio of the minimal lumen diameter to the mean of proximal and distal reference vessel diameters (C). In this case, the minimal lumen diameter, the proximal reference vessel diameter, and the distal reference vessel…

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  Figure 3. Patient flow diagram.

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  Figure 4. CT angiography parameters before and six months after the baseline in the evolocumab and control groups. Minimum CT densities of the vulnerable coronary plaques (A). CT densities of the coronary artery lumen (B). Remodeling indexes of the vulnerable coronary plaques (C). Percent stenosis at vulnerable coronary plaque sites (D). Abbreviations: CT, computed tomography; NS, not significant. * p < 0.001.