Abstract
Introduction
Current guidelines recommend moderate-intensity lipid lowering
(low-density lipoprotein cholesterol, LDL-C of <2.6 mmol/L or 30%–49%
reduction from the baseline) for patients with intermediate 10-year
atherosclerotic cardiovascular disease (ASCVD) risk. The effects of
intensive lipid lowering (LDL-C of <1.8 mmol/L) on coronary
atherosclerotic plaque phenotype and major adverse cardiovascular events
(MACE) in adults with both non-obstructive coronary artery disease (CAD)
and low to intermediate 10-year ASCVD risk remain uncertain.
Methods and analysis
Intensive Lipid-lowering for Plaque and Major Adverse Cardiovascular
Events in Low to Intermediate 10-year ASCVD Risk Population is a
multicentre, randomised, open-label, blinded endpoint clinical trial.
Inclusion criteria are as follows: (1) patients with the age of 40–75
years within 1 month of coronary CT angiography (CCTA) and coronary
artery calcium score (CACS) evaluation; (2) population with low to
intermediate 10-year ASCVD risk (<20%) and (3) patients with
non-obstructive CAD (stenosis <50%) using CCTA. 2900 patients will be
randomly assigned to the intensive lipid lowering (LDL-C of
<1.8 mmol/L or ≥50% reduction from the baseline) or the
moderate-intensity lipid lowering (LDL-C of<2.6 mmol/L or 30%–49%
reduction from the baseline) group in a 1:1 ratio. The primary endpoint
is MACE (composite of all-cause death, non-fatal MI, non-fatal stroke,
any revascularisation and hospitalisation for angina) within 3 years
after enrolment. The secondary endpoints are changes in coronary total
plaque volume (mm3), plaque burden (%), plaque
composition (mm3, %), high-risk plaque
characteristics detected using CCTA and CACS determined using
CT.
Ethics and dissemination
Ethics committee approval for this study was obtained from the
review boards of Fuwai Hospital (No.2022-1787) and all other study
sites. Written informed consent will be obtained from all participants.
The results of this study will be published in peer-reviewed journals
and reported at international conferences.
Trial registration number
NCT05462262.
Funder
Chinese
Academy of Medical Sciences
Cited by
1 articles.
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