{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T07:56:44Z","timestamp":1791705404127,"version":"4.3.4"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The proprotein convertase subtilisin\/kexin Type 9 inhibitor, evolocumab, promoted plaque stabilization on serial imaging in patients following an acute coronary syndrome. The impact of evolocumab in patients with varying lipoprotein(a) [Lp(a)] levels is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Serial optical coherence tomography imaging was performed to evaluate changes in plaque composition in response to treatment with evolocumab 420 mg or placebo for 50 weeks. The current post hoc analysis compared demographics, biochemistry, and plaque imaging changes in those with baseline Lp(a) levels &amp;lt;125 (n = 71) and \u2265125 nmol\/L (n = 46). Among those with high Lp(a) levels, evolocumab treatment produced lower levels of LDL cholesterol (LDL-C) (21.7 \u00b1 10.3 vs. 94.5 \u00b1 22.9 mg\/dL; P &amp;lt; 0.001) and Lp(a) [156.0 (136.0, 187.0) vs. 204.0 (170.5, 290.5) nmol\/L; P = 0.007], compared with placebo. Changes in minimum fibrous cap thickness (FCT) (+51.6 \u00b1 40.9 vs. +12.4 \u00b1 23.9 \u03bcm; P &amp;lt; 0.001) and lipid arc (\u221260.9 \u00b1 56.5\u00b0 vs. \u22129.1 \u00b1 70.8\u00b0; P = 0.008) were greater in the high Lp(a) group with evolocumab compared with placebo. Among patients with low Lp(a) levels, evolocumab produced lower levels of LDL-C (23.3 \u00b1 34.9 vs. 82.9 \u00b1 46.5 mg\/dL; P &amp;lt; 0.001) and Lp(a) [11.5 (5.8, 23.8) vs. 25.0 (13.5, 41.0) nmol\/L; P = 0.01] compared with placebo, but no differences were observed between groups in changes in minimum FCT (+45.9 \u00b1 37.8 vs. +34.7 \u00b1 36.0 \u03bcm; P = 0.21) and lipid arc (\u221259.9 \u00b1 50.1\u00b0 vs. \u221244.5 \u00b1 46.1\u00b0; P = 0.18). Baseline Lp(a) levels significantly interacted with the impact of evolocumab on changes in minimum FCT (interaction P = 0.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The ability of evolocumab to more effectively promote plaque stabilization, compared with statin monotherapy, appears more pronounced in patients with higher Lp(a) levels, suggesting that Lp(a) may help identify those who benefit most from intensive lipid-lowering therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov: NCT03570697<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf211","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T21:41:22Z","timestamp":1744062082000},"page":"2047-2054","source":"Crossref","is-referenced-by-count":8,"title":["Impact of evolocumab on plaque phenotypic changes in patients with acute coronary syndrome and elevated lipoprotein(a) levels: a HUYGENS secondary analysis"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6524-9391","authenticated-orcid":false,"given":"Giuseppe","family":"Di Giovanni","sequence":"first","affiliation":[{"name":"Victorian Heart Institute, Monash University , 631 Blackburn Rd, Clayton, Melbourne 3168 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Fujino","sequence":"additional","affiliation":[{"name":"Victorian Heart Institute, Monash University , 631 Blackburn Rd, Clayton, Melbourne 3168 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-5593","authenticated-orcid":false,"given":"Yu","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cerebral and Cardiovascular Centre , Suita ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Butters","sequence":"additional","affiliation":[{"name":"Victorian Heart Institute, Monash University , 631 Blackburn Rd, Clayton, Melbourne 3168 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hucko","sequence":"additional","affiliation":[{"name":"Amgen Inc. , Thousand Oaks, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8849-7426","authenticated-orcid":false,"given":"Rishi","family":"Puri","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Coordinating Center for Clinical Research, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E","family":"Nissen","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Coordinating Center for Clinical Research, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J","family":"Nelson","sequence":"additional","affiliation":[{"name":"Victorian Heart Institute, Monash University , 631 Blackburn Rd, Clayton, Melbourne 3168 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Psaltis","sequence":"additional","affiliation":[{"name":"Lifelong Health Theme, South Australian Health and Medical Research Institute, Faculty of Health and Medical Sciences, University of Adelaide , Adelaide ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9668-4368","authenticated-orcid":false,"given":"Stephen J","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Victorian Heart Institute, Monash University , 631 Blackburn Rd, Clayton, Melbourne 3168 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"2026090410565016100_zwaf211-B1","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1093\/eurheartj\/ehx144","article-title":"Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. 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