The Inhibition of Evolocumab on Non-Infarct-Related Artery Disease in Patients with ST-Elevation Myocardial Infarction

Abstract

Purpose

The effects of combing evolocumab and statin on the clinical outcome and physiological function of coronary arteries in STEMI patients with non-infarct-related artery (NIRA) disease are still unclear.

Methods

A total of 355 STEMI patients with NIRA were enrolled in this study, who underwent combined quantitative flow ratio (QFR) at baseline and after 12 months of treatment with statin monotherapy or statin plus evolocumab.

Results

Diameter stenosis and lesion length were significantly lower in the group undergoing statin plus evolocumab. While the group exhibited significantly higher minimum lumen diameter (MLD), and QFR values. Statin plus evolocumab (OR = 0.350; 95% CI: 0.149–0.824; P = 0.016) and plaque lesion length (OR = 1.223; 95% CI: 1.102–1.457; P = 0.033) were independently associated with rehospitalization for unstable angina (UA) within 12 months.

Conclusion

Evolocumab combined with statin therapy can significantly improve the anatomical and physiological function of the coronary arteries and downregulate the re-hospitalization rate due to UA in STEMI patients with NIRA.

Keywords:

• PCSK9 inhibition
• C-reactive protein
• inflammation
• physiological assessment
• quantitative flow ratio
• non-infarct-related artery

Data Sharing Statement

Upon reasonable request, the original data can be obtained from the corresponding authors.

Approval of Ethics and Consent to Participate

The ethics committee of 1st Affiliated Hospital of Harbin Medical University has approved the study, which was conducted in view of the principles of the Declaration of Helsinki. Patient consents were obtained in writing by each of participants before participating in the study.

Acknowledgments

Thank you for funding our research. Qi Zhao, Siyuan Sun, and Fanghui Zhou are co-first authors for this study.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

Support for this research comes from the National Natural Science Foundation of China (No. 81970297 and 82270319), and Fund of Key Laboratory of Myocardial Ischemia, Ministry of Education (KF202020/LX).