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

Qi Zhao,1,* Siyuan Sun,2,* Fanghui Zhou,3,* Jingkun Yue,2 Xing Luo,4 Xiufen Qu1 1Department of Cardiology, 1st Affiliated Hospital of Harbin Medical University, Harbin, 150086, People’s Republic of China; 2Department of Cardiology, People’s Hospital of Taihe County, Taihe, Anhui, 236600, People’s Republic of China; 3Department of Hematology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of China; 4Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xing Luo; Xiufen Qu, Email luoxing321@163.com; quxiufenhmu@126.comPurpose: 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: A total of 355 STEMI patients with NIRA were enrolled in this study, who underwent combined quantitative flow ratio (QFR) at baseline and after 12 months of treatment with statin monotherapy or statin plus evolocumab.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; 95% CI: 0.149– 0.824; P = 0.016) and plaque lesion length (OR = 1.223; 95% CI: 1.102– 1.457; P = 0.033) 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.Keywords: PCSK9 inhibition, C-reactive protein, inflammation, physiological assessment, quantitative flow ratio, non-infarct-related artery