Triglyceride-Associated Coronary Lumen Area Increase in Patients Receiving Inclisiran as Add-on Lipid-Lowering Treatment

  • Kokina, B. (Speaker)
  • Trušinskis, K. (Co-author)
  • Lapsovs, M. (Co-author)
  • Mairita Karantajere (Co-author)
  • Evija Knoka (Co-author)
  • Laima Caunite (Co-author)
  • Sanda Jegere (Co-author)
  • Inga Narbute (Co-author)
  • Dace Sondore (Co-author)
  • Indulis Kumsars (Co-author)
  • Andrejs Erglis (Co-author)

Activity: Talk or presentation types › Oral presentation

Description

Triglycerides are an established risk factor for adverse cardiovascular events, though less emphasized for novel PCSK-9 gene-silencing hypolipidaemic medication inclisiran. Aim of this study was to evaluate the effect of inclisiran on plasma triglyceride levels and coronary artery lumen area in intravascular imaging.. Study was conducted among stable coronary artery disease patients admitted for elective percutaneous coronary intervention and having non-haemodynamically significant plaque 20-50% in proximal/middle third of coronary artery, corresponding to segment of interest. Intravascular ultrasound (IVUS) was performed at baseline and after 15 months, evaluating mean lumen area. All participants received statin to maximum tolerated dose and/or ezetimibe for at least one month prior to inclusion. In patients having low-density lipoprotein (LDL-C) levels >1.8 mmol/l, add-on inclisiran was started. Plasma lipid profile changes were also evaluated. For data analysis SPSS Statistics software was used with defined significance level of 0.05.. In 25 eligible patients IVUS investigation was performed, among which 15 were assigned to receive inclisiran. Baseline triglyceride levels were 1.71 (±0.89) mmol/l and 1.52 (±0.45) mmol/l in inclisiran and statin/ezetimibe groups, respectively (P=0.164). In inclisiran group, data demonstrated significant reduction of triglyceride levels by 32.7% (-0.56, 95%CI -0.89 to -0.22, P=0.003) for 15-month pooled data, as well as significant increase of mean lumen area by 8.41% (0.74, 95%CI 0.26 to 1.22, P=0.003). Among statin/ezetimibe users difference of trglyceride levels (-0.10, 95%CI 0.71 to 0.51, P=0.703) and mean lumen area (2.08, 95%CI -0.09 to 4.24, P=0.058) was nonsignificant. Achieved LDL-C levels were similar in both groups – 1.70 (±0.65) mmol/l in patients receiving inclisiran and 1.59 (±0.56) mmol/l in statin/ezetimibe group (P=0.242).. Inclisiran add-on therapy resulted in plasma triglyceride reduction with clinical benefit observed in increase of coronary artery lumen area, when compared to statin and/or ezetimibe alone, in presence of achieved LDL-C target, possibly lowering residual risk.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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