{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:34:19Z","timestamp":1788489259165,"version":"build-2803163510"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Elevated Lp(a) (lipoprotein[a]) is a risk marker for atherosclerotic disease, but the underlying mechanisms remain elusive. We examined the association of Lp(a) with changes in coronary atherosclerosis following intensive lipid-lowering therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\n              In the PACMAN-AMI trial (Effects of the PCSK9 Antibody Alirocumab on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction), 300 patients with acute myocardial infarction were randomized to receive biweekly alirocumab 150 mg or placebo in addition to high-intensity statins. Patients underwent serial 2-vessel intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy in the non\u2013infarct-related arteries at baseline and after 52 weeks. The main end points were percent atheroma volume by intravascular ultrasound, minimum fibrous cap thickness by optical coherence tomography, and maximum lipid core burden index within 4 mm (maxLCBI\n              <jats:sub>4mm<\/jats:sub>\n              ) by near-infrared spectroscopy.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              A total of 265 patients had serial intravascular ultrasound data (mean age, 58\u00b19 years; 16% women). Alirocumab resulted in greater reductions in percent atheroma volume and maxLCBI\n              <jats:sub>4mm<\/jats:sub>\n              , as well as a greater increase in minimum fibrous cap thickness, compared with placebo. In the alirocumab group, the reduction in maxLCBI\n              <jats:sub>4mm<\/jats:sub>\n              was smaller in patients with higher baseline Lp(a), defined by the highest quartile (Q4, \u226598 nmol\/L; n=30), than in those with lower baseline Lp(a) (Q1\u2013Q3, &lt;98 nmol\/L; n=99; \u221240.2 [\u221291.1 to 10.7] versus \u221291.4 [\u2212113.9 to \u221268.9], respectively;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.01 after adjustment for clinically relevant baseline variables), and was comparable to the maxLBI\n              <jats:sub>4mm<\/jats:sub>\n              reduction in the placebo group (\u221237.60 [\u221257.40 to \u221217.80]; n=134). These findings were consistent when higher baseline Lp(a) was defined by cut-off values of \u226575 versus &lt;75 nmol\/L (n=35 versus 94, respectively, in the alirocumab group) and \u2265125 versus &lt;125 nmol\/L (n=23 versus 106, respectively). Changes in percent atheroma volume and minimum fibrous cap thickness did not differ in relation to baseline Lp(a).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>In patients with acute myocardial infarction, elevated Lp(a) at baseline is associated with attenuation of plaque lipid regression despite intensive treatment with alirocumab plus high-intensity statin. This finding may explain the residual cardiovascular risk associated with high Lp(a) despite optimal control of lipid levels.<\/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: NCT03067844.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.124.016683","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T19:00:32Z","timestamp":1732042832000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Association of Lipoprotein(a) With Changes in Coronary Atherosclerosis in Patients Treated With Alirocumab"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct03067844","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5589-7762","authenticated-orcid":true,"given":"Konstantinos C.","family":"Koskinas","sequence":"first","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1420-8967","authenticated-orcid":true,"given":"Jonas","family":"H\u00e4ner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4630-9815","authenticated-orcid":true,"given":"Yasushi","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7737-0374","authenticated-orcid":true,"given":"Tatsuhiko","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Lonborg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (J. Lonborg, T.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3593-3981","authenticated-orcid":true,"given":"Hiroki","family":"Shibutani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1133-2864","authenticated-orcid":true,"given":"Ryota","family":"Kakizaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, Switzerland (C.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2943-5932","authenticated-orcid":true,"given":"Robert-Jan","family":"van Geuns","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Radboud UMC, Nijmegen, the Netherlands (R.-J.v.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7625-3651","authenticated-orcid":true,"given":"Anna S.","family":"Ondracek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Vienna, Austria (A.S.O., M.M.; I.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5416-165X","authenticated-orcid":true,"given":"Fabien","family":"Praz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Amb\u00fchl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Spirk","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology, Bern University Hospital (D.S.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5035-6625","authenticated-orcid":true,"given":"Jonas","family":"Lanz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. Lanz, S.W., L.R.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8628-1410","authenticated-orcid":true,"given":"Joost","family":"Daemen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands (J.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8766-7945","authenticated-orcid":true,"given":"Dik","family":"Heg","sequence":"additional","affiliation":[{"name":"Department of Clinical Research (D.H., S.L.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0597-829X","authenticated-orcid":true,"given":"Manuel","family":"Mayr","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Vienna, Austria (A.S.O., M.M.; I.M.L.)."},{"name":"National Heart and Lung Institute, Imperial College London, United Kingdom (M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3178-9131","authenticated-orcid":true,"given":"Fran\u00e7ois","family":"Mach","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital Geneva, Switzerland (F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2653-6762","authenticated-orcid":true,"given":"Stephan","family":"Windecker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital (K.C.K., J.H., Y.U., T.O., H.S., R.K., F.P., M.A., J. 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