{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T07:47:42Z","timestamp":1793346462815,"version":"4.5.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,7,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">PCSK9 (proprotein convertase subtilisin\/kexin type 9) is well recognized for its important role in cholesterol metabolism. Elevated levels are associated with increased cardiovascular risk and inhibition with PCSK9 antibodies (PCSK9i) lowers cardiovascular events in patients with coronary artery disease. PCSK9 levels are also elevated in people living with HIV (PLWH) and those with dyslipidemia. Because increased PCSK9 in PLWH is associated with impaired coronary endothelial function, a barometer of coronary vascular health, we tested the hypothesis that PCSK9i improves impaired coronary endothelial function in dyslipidemia without coronary artery disease and in PLWH with nearly optimal\/above goal low\u2010density lipoprotein cholesterol levels.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We performed a single\u2010center study in 19 PLWH and 11 with dyslipidemia to evaluate the effects of the PCSK9i evolocumab on coronary endothelial function using cine 3T MRI to noninvasively measure coronary endothelial function, assessed as the changes in coronary cross\u2010sectional area and coronary blood flow from rest to that during isometric handgrip exercise, a known endothelial\u2010dependent vasodilator. Before evolocumab, there was a decrease or no coronary vasodilation and no increase in coronary blood flow (the normal responses) to isometric handgrip exercise in either group. Following 6\u00a0weeks of evolocumab, 480\u00a0mg q4 weeks, the % cross\u2010sectional area changes from rest to isometric handgrip exercise were +5.6\u00b15.5% and +4.5\u00b13.1% in the PLWH and dyslipidemia groups, respectively, both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01 versus baseline. Improved cross\u2010sectional area was paralleled by a significant coronary blood flow improvement in both groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">To our knowledge, these data represent the first evidence that PCSK9 inhibition improves coronary artery health in PLWH and people with dyslipidemia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\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: NCT03500302.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.016263","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T08:56:07Z","timestamp":1594976167000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":71,"title":["Evolocumab, a PCSK9\u2010Monoclonal Antibody, Rapidly Reverses Coronary Artery Endothelial Dysfunction in People Living With HIV and People With Dyslipidemia"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2569-6617","authenticated-orcid":false,"given":"Thorsten M.","family":"Leucker","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6046-6812","authenticated-orcid":false,"given":"Gary","family":"Gerstenblith","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sch\u00e4r","sequence":"additional","affiliation":[{"name":"Division of Magnetic Resonance Research Department of Radiology Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd T.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Department of Medicine Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Jones","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohannes","family":"Afework","sequence":"additional","affiliation":[{"name":"Division of Magnetic Resonance Research Department of Radiology Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2138-1589","authenticated-orcid":false,"given":"Allison G.","family":"Hays","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore 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