Early Effects of Intensive Lipid-Lowering Treatment on Plaque Characteristics Assessed by Virtual Histology Intravascular Ultrasound
Yonsei Medical Journal
;
: 1087-1094, 2016.
Article
in English
| WPRIM
| ID: wpr-34057
ABSTRACT
PURPOSE:
The effects of short-term intensive lipid-lowering treatment on coronary plaque composition have not yet been sufficiently evaluated. We investigated the influence of short-term intensive lipid-lowering treatment on quantitative and qualitative changes in plaque components of non-culprit lesions in patients with acute coronary syndrome. MATERIALS ANDMETHODS:
This was a prospective, randomized, open-label, single-center trial. Seventy patients who underwent both baseline and three-month follow-up virtual histology intravascular ultrasound were randomly assigned to either an intensive lipid-lowering treatment group (ezetimibe/simvastatin 10/40 mg, n=34) or a control statin treatment group (pravastatin 20 mg, n=36). Using virtual histology intravascular ultrasound, plaque was characterized as fibrous, fibro-fatty, dense calcium, or necrotic core. Changes in plaque components during the three-month lipid-lowering treatment were compared between the two groups.RESULTS:
Compared with the control statin treatment group, there was a significant reduction in low-density lipoprotein cholesterol in the intensive lipid-lowering treatment group (-20.4±17.1 mg/dL vs. -36.8±17.4 mg/dL, respectively; p<0.001). There were no statistically significant differences in baseline, three-month follow-up, or serial changes of gray-scale intravascular ultrasound parameters between the two groups. The absolute volume of fibro-fatty plaque was significantly reduced in the intensive lipid-lowering treatment group compared with the control group (-1.5±3.4 mm3 vs. 0.8±4.7 mm3, respectively; p=0.024). A linear correlation was found between changes in low-density lipoprotein cholesterol levels and changes in the absolute volumes of fibro-fatty plaque (p<0.001, R2=0.209).CONCLUSION:
Modification of coronary plaque may be attainable after only three months of intensive lipid-lowering treatment.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Time Factors
/
Coronary Artery Disease
/
Drug Administration Schedule
/
Prospective Studies
/
Treatment Outcome
/
Pravastatin
/
Ultrasonography, Interventional
/
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/
Plaque, Atherosclerotic
/
Ezetimibe, Simvastatin Drug Combination
Type of study:
Controlled clinical trial
/
Observational study
/
Qualitative research
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Yonsei Medical Journal
Year:
2016
Type:
Article
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