TY - JOUR
T1 - Effect of high-intensity statin therapy on atherosclerosis in non-infarct-related coronary arteries (IBIS-4)
T2 - a serial intravascular ultrasonography study
AU - Räber, Lorenz
AU - Taniwaki, Masanori
AU - Zaugg, Serge
AU - Kelbæk, Henning
AU - Roffi, Marco
AU - Holmvang, Lene
AU - Noble, Stephane
AU - Pedrazzini, Giovanni
AU - Moschovitis, Aris
AU - Lüscher, Thomas F
AU - Matter, Christian M
AU - Serruys, Patrick W
AU - Jüni, Peter
AU - Garcia-Garcia, Hector M
AU - Windecker, Stephan
AU - IBIS 4 (Integrated Biomarkers and Imaging Study-4) Trial Investigators (NCT00962416)
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: [email protected].
PY - 2015/2/21
Y1 - 2015/2/21
N2 - Aim The effect of long-term high-intensity statin therapy on coronary atherosclerosis among patients with acute ST-segment elevation myocardial infarction (STEMI) is unknown. The aim of this study was to quantify the impact of high-intensity statin therapy on plaque burden, composition, and phenotype in non-infarct-related arteries of STEMI patients undergoing primary percutaneous coronary intervention (PCI). Methods and results Between September 2009 and January 2011, 103 STEMI patients underwent intravascular ultrasonography (IVUS) and radiofrequency ultrasonography (RF-IVUS) of the two non-infarct-related epicardial coronary arteries (non-IRA) after successful primary PCI. Patients were treated with high-intensity rosuvastatin (40 mg/day) throughout 13 months and serial intracoronary imaging with the analysis of matched segments was available for 82 patients with 146 non-IRA. The primary IVUS end-point was the change in per cent atheroma volume (PAV). After 13 months, low-density lipoprotein cholesterol (LDL-C) had decreased from a median of 3.29 to 1.89 mmol/L (P < 0.001), and high-density lipoprotein cholesterol (HDL-C) levels had increased from 1.10 to 1.20 mmol/L (P < 0.001). PAV of the non-IRA decreased by -0.9% (95% CI: -1.56 to -0.25, P = 0.007). Patients with regression in at least one non-IRA were more common (74%) than those without (26%). Per cent necrotic core remained unchanged (-0.05%, 95% CI: -1.05 to 0.96%, P = 0.93) as did the number of RF-IVUS defined thin cap fibroatheromas (124 vs. 116, P = 0.15). Conclusion High-intensity rosuvastatin therapy over 13 months is associated with regression of coronary atherosclerosis in non-infarct-related arteries without changes in RF-IVUS defined necrotic core or plaque phenotype among STEMI patients.
AB - Aim The effect of long-term high-intensity statin therapy on coronary atherosclerosis among patients with acute ST-segment elevation myocardial infarction (STEMI) is unknown. The aim of this study was to quantify the impact of high-intensity statin therapy on plaque burden, composition, and phenotype in non-infarct-related arteries of STEMI patients undergoing primary percutaneous coronary intervention (PCI). Methods and results Between September 2009 and January 2011, 103 STEMI patients underwent intravascular ultrasonography (IVUS) and radiofrequency ultrasonography (RF-IVUS) of the two non-infarct-related epicardial coronary arteries (non-IRA) after successful primary PCI. Patients were treated with high-intensity rosuvastatin (40 mg/day) throughout 13 months and serial intracoronary imaging with the analysis of matched segments was available for 82 patients with 146 non-IRA. The primary IVUS end-point was the change in per cent atheroma volume (PAV). After 13 months, low-density lipoprotein cholesterol (LDL-C) had decreased from a median of 3.29 to 1.89 mmol/L (P < 0.001), and high-density lipoprotein cholesterol (HDL-C) levels had increased from 1.10 to 1.20 mmol/L (P < 0.001). PAV of the non-IRA decreased by -0.9% (95% CI: -1.56 to -0.25, P = 0.007). Patients with regression in at least one non-IRA were more common (74%) than those without (26%). Per cent necrotic core remained unchanged (-0.05%, 95% CI: -1.05 to 0.96%, P = 0.93) as did the number of RF-IVUS defined thin cap fibroatheromas (124 vs. 116, P = 0.15). Conclusion High-intensity rosuvastatin therapy over 13 months is associated with regression of coronary atherosclerosis in non-infarct-related arteries without changes in RF-IVUS defined necrotic core or plaque phenotype among STEMI patients.
KW - Cardiovascular Agents
KW - Cholesterol, HDL
KW - Cholesterol, LDL
KW - Coronary Artery Disease
KW - Female
KW - Humans
KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors
KW - Male
KW - Middle Aged
KW - Myocardial Infarction
KW - Percutaneous Coronary Intervention
KW - Plaque, Atherosclerotic
KW - Prospective Studies
KW - Rosuvastatin Calcium
KW - Treatment Outcome
KW - Ultrasonography, Interventional
U2 - 10.1093/eurheartj/ehu373
DO - 10.1093/eurheartj/ehu373
M3 - Journal article
C2 - 25182248
SN - 0195-668X
VL - 36
SP - 490
EP - 500
JO - European Heart Journal
JF - European Heart Journal
IS - 8
ER -