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Present lesion-level analysis assessed the effects on coronary segments with advanced atherosclerotic plaque characteristics with increased cardiovascular risk and includes all patients who underwent successful serial intravascular ultrasound-near-infrared spectroscopy (IVUS-NIRS) imaging and with presence of IVUS-derived atherosclerotic lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 126 lesions were identified in 85 patients (mean age 65.1\u2009\u00b1\u20098.3, 18.8% female), of which 65 lesions were found in the evolocumab group (44 patients) and 61 in the placebo group (41 patients). Compared to placebo, patients treated with evolocumab did not demonstrate significant reductions in maximum lipid core index within any 4\u00a0mm\u00a0segment (maxLCBI\n                      <jats:sub>4mm<\/jats:sub>\n                      , between-group difference, \u22129.6 [95% CI, \u221252.8 to 33.6];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7) or percent atheroma volume (PAV, between-group difference, 1.0% [95% CI, \u22121.3 to 3.2];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.4). However, an overall reduction in maxLCBI\n                      <jats:sub>4mm<\/jats:sub>\n                      (overall change, \u221254.2 [95% CI, \u221289.6 to \u221218.7];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and PAV (overall change, \u22122.0% [95% CI, \u22123.9 to \u22120.1];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with placebo, the addition of evolocumab did not yield incremental improvements in lesion-level atheroma burden in the first 12\u00a0weeks after ACS. However, in the pooled analysis, significant short-term reductions in atheroma volume and plaque lipid content were observed.<\/jats:p>\n                    <jats:p>Trial registration number: clinicaltrials.gov NCT04141579.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-02869-8","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T07:46:20Z","timestamp":1774251980000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Short-term lesion-level impact of extensive LDL-C reduction with statins and PCSK9\u00a0inhibitors: a\u00a0pre-specified subgroup analysis of the randomized FITTER trial"],"prefix":"10.1007","author":[{"given":"Jonathan","family":"Los","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans B.","family":"Mensink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed M.","family":"Reda Morsy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Nishimiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit M.","family":"Oemrawsingh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.J.","family":"IJsselmuiden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Meuwissen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin M.","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Himanshu","family":"Rai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim J.F","family":"ten Cate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Camaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Damman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lokien X.","family":"van Nunen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aukelien C.","family":"Dimitriu-Leen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen H.","family":"van Wely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysun","family":"Cetinyurek-Yavuz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Byrne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"van Royen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2943-5932","authenticated-orcid":false,"given":"Robert-Jan M.","family":"van Geuns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"issue":"19","key":"2869_CR1","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1093\/eurheartj\/ehu505","volume":"36","author":"T Jernberg","year":"2015","unstructured":"Jernberg T, Hasvold P, Henriksson M, Hjelm H, Thuresson M et al (2015) Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term perspective. 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Approval was granted by the Dutch Ethical Review Board (METC Oost Nederland).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Mohamed M. Reda Morsy received funding from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) education and training grants program.Kensuke Nishimiya reports research fellowships from Canon Foundation in Europe and the Japanese Grants-in-Aid for Scientific Research (22K08146).Rohit M. Oemrawsingh reports speaker fees from Abbott Vascular and Terumo.Alexander J.J. Ijsselmuiden reports institutional fees from Medtronic, Meril and Abbott and consulting fees from Meril, Angiocare, Abbott, Philips, and Translumina.Cyril Camaro reports institutional speaker fees from Astra Zeneca for regional interventional cardiology meetings.Peter Damman reports research grants from Abbott, Philips, Pie Medical Imaging, and Astra Zeneca and consulting fees from Philips and Abbott.Marleen H. van Wely reports consulting fees from Boston scientific and Abbott vascular.Prof. Robert A. Byrne reports grants received by the institutions of employment for research or education from Abbott Vascular, Biosensors, Boston Scientific, and Translumina without impact on personal remuneration and does not accept personal payments from the medical device or pharmaceutical industry.Prof. van Royen reports research grants from Biotronik, Abbott, Medtronic, and Philips and speaker fees from Abbott, RainMed, Microport, and Bayer.Prof. van Geuns reports consulting and speaker fees from Abbott Vascular and Astra Zeneca. Prof. van Geuns received institutional research grants from Amgen, InfraRedx, Astra Zeneca, and Sanofi.All other authors report no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Radboudumc (sponsor) manages the collection, management, analysis, and interpretation of data; writing of the report; and the decision to submit the report for publication, with ultimate authority over these activities.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Trial sponsor: Radboudumc"}}]}}