Comparison of Intensive Versus Moderate Lipid-Lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-Rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging

The American Journal of Cardiology
Jingbo HouIk-Kyung Jang

Abstract

Despite marked clinical benefit, reduction in atheroma volume with statin therapy is minimal. Changes in plaque composition may explain this discrepancy. We aimed in the present study to assess the effect of statin therapy on coronary plaque composition and plaque volume using serial multimodality imaging. From an open-label, single-blinded study, patients with angiographically mild-to-moderate lesion were randomized to receive atorvastatin 60 (AT 60) mg or atorvastatin 20 (AT 20) mg for 12 months. Optical coherence tomography was used to assess fibrous cap thickness (FCT) and intravascular ultrasound to assess atheroma burden at 3 time points: baseline, at 6 months, and at 12 months. Thirty-six lipid-rich plaques in 27 patients with AT 60 mg and 30 lipid-rich plaques in 19 patients with AT 20 mg were enrolled in this study. Low-density lipoprotein cholesterol level was significantly decreased at 6 months without further reduction at 12 months. AT 60 mg induced greater reduction in low-density lipoprotein cholesterol compared with AT 20 mg. Optical coherence tomography revealed continuous increase in FCT from baseline to 6 months and to 12 months in both groups. AT 60 mg induced greater increase in FCT compared with AT 20 mg at...Continue Reading

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Citations

Sep 20, 2015·BMC Medicine·Maciej BanachUNKNOWN Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group
Feb 28, 2017·Journal of Atherosclerosis and Thrombosis·Yu KataokaStephen J Nicholls
Mar 4, 2017·Expert Review of Cardiovascular Therapy·Kush PatelChristos V Bourantas
Jan 24, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Abigail AfolabiBo Yu
Nov 2, 2018·Heart·Jason M TarkinJames H F Rudd
May 24, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Yuichi OzakiRon Waksman
Jul 18, 2020·European Heart Journal·Rocco A MontoneIk-Kyung Jang
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Aug 28, 2020·The New England Journal of Medicine·Rocco Vergallo, Filippo Crea
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Mar 18, 2020·European Cardiology·Thomas D HeseltineMichael Fisher
Apr 18, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Maoen XuBo Yu

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