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. 2020 Jul 16;9(7):2256.
doi: 10.3390/jcm9072256.

Effects of Evolocumab on Carotid Intima-Media Thickness and Clinical Parameters in Patients Taking a Statin

Keiji Hirai  1 , Shigeki Imamura  2 , Aizan Hirai  2 , Susumu Ookawara  1 , Yoshiyuki Morishita  1
Affiliations

Effects of Evolocumab on Carotid Intima-Media Thickness and Clinical Parameters in Patients Taking a Statin

Keiji Hirai et al. J Clin Med. .

Abstract

We determined the effects of evolocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, on carotid intima-media thickness (IMT) and the factors associated with the change in carotid IMT in patients taking a statin. The change in carotid mean and maximum IMT before and after the initiation of evolocumab treatment was retrospectively analyzed in 229 statin-treated patients. The changes in clinical parameters, including serum lipid concentrations, were also evaluated. Evolocumab significantly reduced the increase in carotid mean and maximum IMT (0.09 ± 0.13 mm/year to -0.04 ± 0.16 mm/year, p < 0.001 and 0.17 ± 0.38 mm/year to 0.08 ± 0.47 mm/year, p = 0.02). Evolocumab reduced serum total cholesterol, low-density lipoprotein-cholesterol, triglyceride, and lipoprotein (a) concentrations (each p < 0.001), and increased serum high-density lipoprotein (HDL)-cholesterol concentrations (p = 0.01). Multiple linear regression analysis revealed that the change in HDL-cholesterol (standard coefficient (β) = -0.120, p = 0.04) and carotid mean IMT (β = -0.467, p < 0.001) were independently correlated with the change in carotid mean IMT during the administration of evolocumab, whereas the change in HDL-cholesterol (β = -0.208, p = 0.002) and log-triglyceride (β = -0.167, p = 0.01) independently correlated with the change in carotid maximum IMT. Evolocumab reduced the increase in carotid IMT in patients taking a statin. These results suggest that evolocumab is protective against carotid atherosclerosis in patients undergoing statin therapy.

Keywords: atherosclerosis; carotid intima-media thickness; evolocumab; proprotein convertase subtilisin/kexin type 9.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Longitudinal B-mode ultrasonographic images of the common carotid artery. (A) Intima-media thickness (IMT) was measured as the distance between the lumen-intima interface (black arrow) and the media-adventitia interface (gray arrow). (B) The maximum IMT was recorded as the largest IMT value measured on both sides of the common carotid artery, carotid bulb, and internal carotid artery (two-headed arrow). Abbreviation—IMT, intima-media thickness.
Figure 3
Figure 3
Participant flow diagram.
Figure 4
Figure 4
Distribution of participants according to the change in carotid mean IMT during the 12 months before and after the administration of evolocumab.
Figure 5
Figure 5
Change in carotid mean IMT during the 12 months before and after the initiation of evolocumab treatment. * p < 0.001.
Figure 6
Figure 6
Distribution of participants according to the change in carotid maximum IMT during the 12 months before and after the administration of evolocumab.
Figure 7
Figure 7
Change in carotid maximum IMT during the 12 months before and after the initiation of evolocumab treatment. * p = 0.02.
See this image and copyright information in PMC

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