CAPRA-EVO: a Randomized Serial PCCT Trial of Early Evolocumab After ACS
Recruiting · NCT07612774 · Interventional (participants receive a specific treatment) · Lead sponsor: West China Hospital
View the official record on ClinicalTrials.gov →Interventions studied
What this trial is about
The CAPRA-EVO trial is a single-center, randomized, open-label study with blinded endpoint assessment comparing early evolocumab plus standard lipid-lowering therapy versus standard-of-care lipid-lowering therapy in patients with acute coronary syndrome after successful percutaneous coronary intervention. The study will use serial photon-counting coronary computed tomography angiography at baseline and 52 weeks to assess changes in non-culprit coronary plaque burden and stenosis severity. Secondary outcomes include changes in high-risk plaque features, lipid and inflammatory biomarkers, cardiovascular events, and safety outcomes. The trial aims to determine whether early intensive LDL-C lowering with evolocumab can reduce coronary plaque progression and support PCCT-CCTA as a noninvasive tool for monitoring atherosclerotic plaque dynamics.
Who can take part
Inclusion criteria
- Eligible patients must meet the following criteria:
- Age between 40 and 75 years.
- Diagnosis of ACS, including ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) or unstable angina (UA).
- Successful PCI treatment, with post-procedural TIMI grade 3 flow and residual stenosis \<30% and atherosclerotic plaque presence in non-culprit coronary vessels (not attributed to this target event).
- Suboptimal LDL-C control: Patients must have received any statin treatment for at least 4 weeks, with an LDL-C level ≥1.8 mmol/L; or Statin-naive patients must have an LDL-C level ≥3.2 mmol/L.
- Agreement to complete baseline CCTA and laboratory tests within 7 days of enrollment and signed informed consent.
- Commitment to complete 52 weeks of follow-up.
Exclusion criteria
- History of coronary artery bypass grafting (CABG).
- History of valve surgery.
- History of PCI treatment before the index ACS event
- Complex bifurcation lesions (Medina 1,1,1).
- Use of PCSK9 inhibitors (e.g., evolocumab, alirocumab) or potent CYP3A4 inhibitors (e.g., itraconazole) within the last 12 months.
- Known intolerance to statins, evolocumab, or other investigational drugs related to the study.
- Hepatic or renal insufficiency (eGFR \<60 mL/min/1.73m² or ALT/AST \>3 times the upper limit of normal).
- Active autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus).
- Uncontrolled heart failure (NYHA class III-IV) or malignant arrhythmias.
- Known allergy or hypersensitivity to iodinated contrast media
- Hyperthyroidism or active thyroid disease
- Pregnancy or breastfeeding (or plans for pregnancy within the next year).
- Life expectancy of less than 1 year (e.g., due to advanced malignancy).
- Participation in another interventional clinical trial within the past 3 months.
Where it is running
1 location listed.
- West China Hospital of Sichuan University - Chengdu, Sichuan, China