Mar 4, 2023 / Nov 16, 2024
YELLOW III
Effect of Evolocumab on Coronary Plaque Characteristics
Study Overview
On this page: Publications · Conference abstracts · News & Media
This study aims to evaluate the impact of evolocumab on coronary plaque characteristics in patients with stable coronary artery disease (CAD) already on maximally tolerated statin therapy. Using intravascular imaging and PBMC gene expression analysis, the research integrates imaging techniques with machine learning-based transcriptomic analysis to identify molecular mechanisms driving beneficial changes in atherosclerotic plaques. The primary endpoints include changes in minimal fibrous cap thickness (FCT) measured by optical coherence tomography (OCT) and maxLCBI4mm assessed by near-infrared spectroscopy (NIRS) over 26 weeks of treatment. Secondary endpoints involve changes in lipid and macrophage-related plaque features assessed by OCT, plaque volume changes by intravascular ultrasound (IVUS), and PBMC gene expression profiles.
Part 1 – Imaging
Part 2 – Transcriptomic
Part 2 – Transcriptomic
Yellow III Transcriptomic Results Presentation
Publications
Peer-reviewed papers from the YELLOW III trial, led by Annapoorna S. Kini, MD.
Primary results · JACC: Cardiovascular Imaging · 2026
Intracoronary Imaging and Transcriptomic Characteristics Before and After Maximum Lipid-Lowering Therapy: YELLOW-III Study of Evolocumab and Maximum Statin Therapy in Chronic Coronary Disease
Kini AS, Vengrenyuk Y, Liu J, et al.
JACC Cardiovasc Imaging. 2026;19(4):516-534. doi:10.1016/j.jcmg.2025.12.013
Substudy · European Heart Journal – Imaging Methods and Practice · 2026
Intra-coronary imaging and transcriptomics of calcified nodules before and after intensive lipid-lowering therapy: a YELLOW III substudy
Revaiah PC, Vengrenyuk Y, Liu J, … Kini AS.
Eur Heart J Imaging Methods Pract. 2026;4(1):qyag092. doi:10.1093/ehjimp/qyag092
Substudy · Atherosclerosis · 2026
Serial OCT-based coronary physiology and plaque composition in vessels with nonobstructive coronary lesions following intensive lipid-lowering therapy: YELLOW III sub-study
Revaiah PC, Vengrenyuk Y, Santosh VK, … Kini AS.
Atherosclerosis. 2026;419:120836. doi:10.1016/j.atherosclerosis.2026.120836
Post hoc analysis · International Journal of Cardiovascular Imaging · 2026
Sex differences in coronary plaque stabilization with evolocumab: a post hoc analysis of the YELLOW III trial
Yasumura K, Goldman S, Vengrenyuk Y, … Kini AS.
Int J Cardiovasc Imaging. 2026 Sep 5. Online ahead of print. doi:10.1007/s10554-026-03824-4
Case report · JACC: Case Reports · 2026
The "Melting Butter Sign" of Coronary Plaque Delipidation: Insights From the YELLOW III Trial
Yasumura K, Vengrenyuk Y, Revaiah PC, … Kini AS.
JACC Case Rep. 2026;110611. In press. doi:10.1016/j.jaccas.2026.110611
Substudy · Cardiovascular Drugs and Therapy · 2026
Impact of Diabetes on Coronary Plaque Stabilization With Evolocumab: Insights From the YELLOW III Trial
Yasumura K, Vengrenyuk Y, Liu J, … Kini AS.
Cardiovasc Drugs Ther. 2026 Sep 24. Online ahead of print. doi:10.1007/s10557-026-07962-8
News & Media
Beyond the Data: YELLOW III: PCSK9 Inhibitors and Plaque Characterization
TCTMD – March 5, 2023
Clues to Evolocumab Response Exist in Patients’ Genes: YELLOW III
TCTMD – November 21, 2024
Stable CAD Plaque Morphology Improved by PCSK9 Inhibitors: YELLOW III
TCTMD – March 04, 2023
YELLOW III Study Improves Understanding of Evolocumab in CAD Treatment
HCPLive – March 05, 2023
ACC 23: Effect of Evolocumab on Coronary Plaque Morphology: The YELLOW III Study
ICRJournal – March 05 2023
Annapoorna Kini, ACC 2023: PCSK9 inhibitors for acute coronary syndrome
Touch Cardio – March 30 2023
Imaging data may predict best responders to evolocumab therapy: YELLOW III
Healio – March 04, 2023
Yellow III Trial Finds That Lipid Lowering With a PCSK9 Inhibitor Could Benefit Heart Patients on Statin Therapy
Mount Sinai – April 07, 2023
Conference Abstracts
Research presented at scientific meetings from the YELLOW III trial.
Moderated poster · ACC.26 · Mar 28, 2026
Physiological Changes in Non-Obstructive Coronary Lesions Before and After Maximal Lipid-Lowering Therapy Using AI-Based Optical Flow Ratio: Insights From the YELLOW III Study
Chenniganahosahalli P, Vengrenyuk Y, Yasumura K, … Kini AS.
J Am Coll Cardiol. 2026;87(13 Suppl). doi:10.1016/j.jacc.2026.02.2173
Poster · ACC.26 · Mar 29, 2026
AI-Based Angiography-Derived Radial Wall Strain in Non-Obstructive Coronary Lesions Before and After Maximal Lipid-Lowering Therapy: Insights From the YELLOW III Study
Chenniganahosahalli P, Vengrenyuk Y, Vemuri K, … Kini AS.
J Am Coll Cardiol. 2026;87(13 Suppl):A881. doi:10.1016/j.jacc.2026.02.2175
Poster · ACC.26 · Mar 29, 2026
Impact of Maximal Lipid-Lowering Therapy on the Physiological Disease Pattern Using AI-Based Virtual µFR Pullback Curve: Insights From the YELLOW III Study
Chenniganahosahalli P, Vengrenyuk Y, Yasumura K, … Kini AS.
J Am Coll Cardiol. 2026;87(13 Suppl). doi:10.1016/j.jacc.2026.02.2176
Poster · ACC.26 · Mar 29, 2026
Intracoronary Imaging Insights Into the Morphology of Calcified Nodules Before and After Maximal Lipid-Lowering Therapy: A Substudy of YELLOW III
Chenniganahosahalli P, Vengrenyuk Y, Yasumura K, … Kini AS.
J Am Coll Cardiol. 2026;87(13 Suppl). doi:10.1016/j.jacc.2026.02.2177