# Serial Coronary Plaque Composition After Inclisiran Initiation Assessed by Automated CCTA: A Retrospective Pilot Study

Article · Kawada K, Suzuki M, Mochizuki J, Matsumi H, Miura D, Hata Y

- Archive id: doi:10.3390/diagnostics16183009
- Published: 2026-09-17
- Venue: Diagnostics (Basel, Switzerland)
- DOI: https://doi.org/10.3390/diagnostics16183009
- PMID: 42793794
- PMCID: PMC13604977
- Citations: 0
- Source URL: https://doi.org/10.3390/diagnostics16183009
- PDF: https://europepmc.org/articles/PMC13604977/pdf
- Provenance: europepmc

## Abstract

Background/Objectives : Inclisiran provides durable low-density lipoprotein cholesterol (LDL-C) lowering, but serial coronary plaque composition after treatment initiation remains incompletely characterized. This study evaluated temporal plaque changes using automated coronary computed tomography angiography (CCTA). Methods : In this uncontrolled, retrospective, observational pilot study, consecutive patients who initiated inclisiran between 1 January 2024 and 29 April 2026 were screened. A random-intercept mixed-effects model included every eligible quantitative plaque observation obtained by the prespecified data cutoff. Results : Of the 230 screened patients, 215 contributed 468 plaque observations (baseline, n = 186; 3 months, n = 196; 15 months, n = 86); 74 had all three examinations. The LDL-C levels decreased from 117.4 mg/dL (95% confidence interval \[CI\], 113.3-121.6) to 45.9 mg/dL (39.5-52.3) at 15 months. No significant time effect was detected for the total plaque volume ( p = 0.713). Low-density non-calcified plaque (LDNC) decreased from 27.3 mm 3 (23.1-31.6) to 22.7 mm 3 (18.0-27.4; overall p = 0.0035), whereas calcified plaque increased from 56.5 mm 3 (45.6-67.3) to 67.1 mm 3 (55.9-78.2; p \< 0.0001). The adjusted baseline-to-15-month differences were -4.64 mm 3 for LDNC (95% CI, -7.54 to -1.74; Bonferroni-adjusted p = 0.0052) and +10.60 mm 3 for calcified plaque (6.60-14.60; adjusted p \< 0.0001). In the tube voltage-adjusted sensitivity analysis of 107 patients and 278 observations, these findings were maintained. Conclusions : Patients initiating inclisiran showed temporal changes in attenuation-defined plaque composition. The uncontrolled design, incomplete acquisition data in the expanded cohort, and technical variability preclude causal or histologic interpretation.

_Abstract reproduced under CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)._

Topics: [Cardiovascular Therapeutics](https://space-kitty.com/topics/cardiovascular-innovation)

---
Space Kitty Archive · https://space-kitty.com · API: https://space-kitty.com/api/v1 · MCP: https://space-kitty.com/mcp · Premium: $0.20/request via x402 (Base Sepolia (testnet)). Metadata: arXiv (CC0), OpenAlex (CC0), Europe PMC (CC BY/CC0 works), ClinicalTrials.gov.