Effect of evolocumab on blood lipid level and plaque properties in patients with coronary artery disease after application of drug-coated balloon
Objective To investigate the effect of evolocumab on blood lipid level,plaque structure and stability in the patients with coronary artery disease after application of drug-coated balloon.Methods A total of 80 coronary artery disease patients with blood lipid level unreaching standard after application of drug-coa-ted balloon in this hospital from September 2020 to March 2022 were selected and divided into the control group(continue with the original statin therapy,n=42)and observation group(combined with evolocumab based on the original statin therapy,n=38)according to the treatment method.The general data,blood lipid levels at baseline and after 6 and 9 months of follow-up,optical coherence tomography(OCT)related indica-tors at baseline and after 9-month follow-up were compared between the two groups,and the clinical endpoint events and the incidence of related adverse drug reactions during follow-up were recorded.Results There was no statistically significant difference in terms of age,gender,BMI,type of acute coronary syndrome,cardiovas-cular risk factors,use of secondary prevention medications for coronary artery disease,and blood lipid levels and OCT related indicators at baseline between the two groups(P＞0.05).The results of two-factor repeated measures ANOVA showed that low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein choles-terol(HDL-C)and triglyceride(TG)levels had statistically significant differences in groups,time and inter-action between groups(P＜0.05).After 6,9 months of follow-up,the LDL-C level in the two groups and the TG level in the observation group were gradually decreased(P＜0.05),moreover the LDL-C level in the ob-servation group was significantly lower than that in the control group(P＜0.05),while no significant differ-ence was found in the levels of HDL-C and TG between the two groups(P＞0 05).After 9-month follow-up,the plaque burden in the observation group was lower than the baseline value and that in the control group,the minimum fibrous cap thickness and minimum lumen area were higher than the baseline values and those in the control group,and the differences were statistically significant(P＜0.05).During the follow-up period,no drug withdrawal due to serious adverse reactions,acute cardiovascular events or death events occurred in the two groups,and two patients in the control group underwent percutaneous coronary intervention again.Con-clusion Combing with evolocumab based on statin therapy could further reduce the LDL-C level in the pa-tients,reduce plaque volume and enhance plaque stability.
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