mAY, 2026

The Yellow Family of Studies of Atherosclerosis Regression

From Intracoronary Imaging, Transcriptomics to Biomarkers

The YELLOW Family of Studies Presentation

A lecture on the YELLOW trials and what they reveal about coronary plaque regression, intensive lipid-lowering therapy, cholesterol efflux, inflammation, PCSK9 inhibition, and the emerging importance of mitochondrial health in stabilizing atherosclerotic plaque.

Presentation Time Stamps

00:01:51 Dr. Annapoorna Kini – Introduction to the YELLOW trial series and why it was created

00:03:14 Dr. Annapoorna Kini – Meaning of “YELLOW” and focus on reducing lipid-rich coronary plaque

00:04:03 Dr. Annapoorna Kini – YELLOW 1: statin therapy, FFR, NIRS imaging, and lipid-rich plaque reduction

00:10:11 Dr. Annapoorna Kini – YELLOW 2: OCT imaging, HDL function, macrophages, cholesterol efflux, and ABCA1

00:18:33 Dr. Annapoorna Kini – YELLOW 2 results: statin responders vs. non-responders and fibrous cap improvement

00:24:00 Dr. Annapoorna Kini – YELLOW 3: PCSK9 inhibition with evolocumab plus statins

00:26:52 Dr. Annapoorna Kini – The key problem of plaque non-responders despite very low LDL

00:28:03 Dr. Annapoorna Kini – Transcriptomics findings: mitochondrial function and inflammatory pathways

00:31:51 Dr. Annapoorna Kini – Biological explanation of plaque stabilization: mitochondria, macrophages, lipid core, and fibrous cap

00:35:02 Dr. Annapoorna Kini – Lifestyle factors: diet, exercise, mitochondrial health, and prevention

00:37:49 Dr. Annapoorna Kini – Future direction / YELLOW 4: biomarkers, omics, AI, and personalized CAD treatment

00:42:35 Dr. Pedro Moreno – Plaque regression as restoration of vascular health

00:44:09 Dr. Pedro Moreno – Macrophages, inflammation resolution, reverse cholesterol transport, and cholesterol efflux

00:52:42 Dr. Pedro Moreno – Fibrous cap healing and plaque stabilization mechanisms

00:55:16 Dr. Pedro Moreno – The “deceiving non-responder” with very low LDL but no plaque improvement

01:00:47 Dr. Pruthvi C. Revaiah – Imaging-based sub-studies from the YELLOW trials

01:01:28 Dr. Pruthvi C. Revaiah – Review of IVUS, OCT, NIRS, angiography-derived physiology, microFFR, and OCT-derived FFR

01:06:39 Dr. Pruthvi C. Revaiah – Radial wall strain and lipid-to-cap ratio as plaque vulnerability markers

01:12:40 Dr. Pruthvi C. Revaiah – Pullback pressure gradient and focal vs. diffuse coronary disease

01:17:33 Dr. Pruthvi C. Revaiah – YELLOW 3 imaging results after evolocumab plus statin therapy

01:22:32 Dr. Jagat Narula – Broader interpretation of the YELLOW studies and mitochondrial biology

01:25:21 Dr. Jagat Narula – PCSK9, LDL burden, mitochondrial stress, and CHIP as drivers of atherosclerosis

01:28:44 Dr. Jagat Narula – Lifetime LDL exposure and importance of earlier LDL lowering

01:31:33 Dr. Jagat Narula – Mitochondrial stress, inflammation, and PCSK9-related biology

01:35:34 Dr. Jagat Narula – CHIP, inflammatory pathways, and possible combination therapies

01:42:29 Dr. Jagat Narula – Evolutionary role of PCSK9 and how modern diet may affect cardiovascular risk

01:55:45 Dr. Valentin Fuster – Panel discussion: liver, vascular wall, bone marrow, macrophages, and inflammation

01:58:14 Dr. Greg Stone – Complexity of atherosclerosis and identifying non-responders

02:02:02 Dr. Sandy Friedman – Practical prevention: aggressive LDL lowering, calcium scoring, Lp(a), apoB, and healthcare delivery

02:09:44 Dr. Rosenson – Lp(a), statins, fibrous cap thickness, biomarkers, and future Lp(a)-lowering trials

02:13:40 Dr. Valentin Fuster – Final patient-facing message about prevention and personal responsibility

02:17:06 Dr. Annapoorna Kini – Closing remarks and future meeting topics

02:17:47 Dr. Samin Sharma – Final acknowledgments and praise for the YELLOW trial program

Featuring

Annapoorna S. Kini

MD

Jagat Narula

MD, PHD

Pedro Moreno

MD

Pruthvi C. Revaiah

MD, PHD