{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:36:54Z","timestamp":1791545814726,"version":"4.3.4"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Intensive lipid-lowering therapy may induce coronary atherosclerosis regression. Nevertheless, the factors underlying the effect of lipid-lowering therapy on disease regression remain poorly characterized. Our aim was to determine which characteristics of atherosclerotic plaque are associated with a greater reduction in coronary plaque burden (PB) after treatment with alirocumab in patients with familial hypercholesterolemia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>The ARCHITECT study (Effect of Alirocumab on Atherosclerotic Plaque Volume, Architecture and Composition) is a phase IV, open-label, multicenter, single-arm clinical trial to assess the effect of the treatment with alirocumab for 78 weeks on the coronary atherosclerotic PB and its characteristics in subjects with familial hypercholesterolemia without clinical atherosclerotic cardiovascular disease. Participants underwent a coronary computed tomographic angiography at baseline and a final one at 78 weeks. Every patient received alirocumab 150 mg subcutaneously every 14 days in addition to high-intensity statin therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              One hundred and four patients were enrolled. Median age was 53.3 (46.2\u201359.4) years and 54 were women (51.9%). The global coronary PB changed from 34.6% (32.5%\u201336.8%) at entry to 30.4% (27.4%\u201333.4%) at follow-up, which is \u22124.6% (\u22127.7% to \u22121.9%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) reduction. A decrease in the percentage of unstable core (fibro-fatty+necrotic plaque; from 14.1 [7.9\u201322.3] to 8.0 [6.4\u201310.6]; \u22126.6%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) was found. A greater PB (\u03b2, 0.36 [0.13\u20130.59];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.002) and a higher proportion of unstable core (\u03b2, 0.15 [0.08\u20130.22];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) were significantly related to PB regression.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Treatment with alirocumab in addition to high-intensity statin therapy might produce a greater PB regression in patients with familial hypercholesterolemia with higher baseline PB and in those with larger unstable core. Further studies are needed to corroborate the hypothesis raised by these results.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT05465278.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.123.016206","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T10:00:12Z","timestamp":1704967212000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Characteristics of Coronary Atherosclerosis Related to Plaque Burden Regression During Treatment With Alirocumab: The ARCHITECT Study"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct05465278","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9706-7783","authenticated-orcid":true,"given":"Leopoldo","family":"P\u00e9rez de Isla","sequence":"first","affiliation":[{"name":"Cardiology Department, Clinico San Carlos University Hospital, Madrid, Spain (L.P.d.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9194-495X","authenticated-orcid":true,"given":"Jose L.","family":"D\u00edaz-D\u00edaz","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Abente y Lago, A Coru\u00f1a, Spain (J.L.D.-D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2794-9710","authenticated-orcid":true,"given":"Manuel J.","family":"Romero","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Infanta Elena, Huelva, Spain (M.J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2230-6556","authenticated-orcid":true,"given":"Ovidio","family":"Mu\u00f1iz-Grijalvo","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Virgen del Roc\u00edo, Sevilla, Spain (O.M.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5746-1284","authenticated-orcid":true,"given":"Juan D.","family":"Mediavilla","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0758-0848","authenticated-orcid":true,"given":"Rosa","family":"Arg\u00fceso","sequence":"additional","affiliation":[{"name":"Endocrinology Department, Hospital Universitario Lucus Augusti, Lugo, Spain (R.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9184-6399","authenticated-orcid":true,"given":"Raimundo","family":"de Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Madrid, Spain (R.d.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4584-7366","authenticated-orcid":true,"given":"Francisco","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Lipid and Atherosclerosis Unit, CIBERObn, IMBIC, Hospital Universitario Reina Sofia, C\u00f3rdoba, Spain (F.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0055-8875","authenticated-orcid":true,"given":"Juan F.","family":"S\u00e1nchez Mu\u00f1oz-Torrero","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital San Pedro de Alc\u00e1ntara, C\u00e1ceres, Spain 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