The inhibition of Evolocumab on Non-Infarct-Related Artery Disease in Patients with ST-Elevation Myocardial Infarction

Abstract Purpose: The effects of combing evolocumab and statin on the clinical outcome and physiological function of coronary arteries in STEMI patients with non-infarct-related artery (NIRA) disease are still unclear. Methods:355 STEMI patients with NIRA were enrolled in this study, who underwent combined anatomical and physiological assessments at baseline and after 12 months of treatment with statin monotherapy or statin plus evolocumab. Plaque composition and functional ischemia were determined via using the quantitative coronary angiography (QCA) and quantitative flow ratio (QFR). Results: Diameter stenosis and lesion length were significantly lower in the group undergoing statin plus evolocumab. While the group exhibited significantly higher minimum lumen diameter (MLD), and QFR values. Statin plus evolocumab (OR=0.350) and plaque lesion length (OR=1.223) were independently associated with rehospitalization for unstable angina (UA) within 12 months. Conclusion: Evolocumab combined with statin therapy can significantly improve the anatomical and physiological function of the coronary arteries and downregulate the re-hospitalization rate due to UA in STEMI patients with NIRA.