医学
传统PCI
Evolocumab公司
心脏病学
经皮冠状动脉介入治疗
内科学
冠状动脉疾病
心肌梗塞
临床终点
随机对照试验
人口
胆固醇
载脂蛋白B
环境卫生
载脂蛋白A1
作者
Masanori Asakura,Kiyoshi Hibi,Wataru Shimizu,Kenshi Fujii,Satoru Suwa,Yasuo Okumura,Toshiaki Mano,Masataka Igeta,Rei Okamoto,Masaharu Ishihara
标识
DOI:10.1016/j.jjcc.2021.08.024
摘要
Percutaneous coronary intervention (PCI) is a standard treatment in patients with stable coronary artery disease (CAD); however, periprocedural myocardial infarction (PMI) remains a common complication of PCI. Aggressive lipid-lowering therapy with statin has shown to reduce the incidence of PMI by preventing coronary microvascular dysfunction. It is unclear whether evolocumab, a potent lipid-lowering agent, could diminish microvascular damage after PCI. The EVOCATION trial (jRCTs051180022) is a multicenter, randomized, open-label, active-controlled, parallel-group, exploratory, investigator-initiated clinical study to evaluate whether pretreatment with evolocumab could decrease the index of microvascular resistance (IMR) after PCI in patients with stable CAD. This study population consists of 100 patients with stable CAD who will undergo PCI and have high low-density lipoprotein cholesterol levels despite administration of maximum tolerated dose of statins for at least 2 weeks. Eligible patients are randomized in a 1:1 ratio to receive either evolocumab 140 mg every 2 weeks in addition to standard of care treatment or standard of care treatment only for 2-6 weeks before PCI. The primary endpoint is IMR after PCI. The EVOCATION trial will evaluate whether pretreatment with evolocumab reduces periprocedural microvascular damage in patients with stable CAD undergoing PCI.
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