Effect of high-intensity statin therapy on atherosclerosis in non-infarct-related coronary arteries (IBIS-4): a serial intravascular ultrasonography study

Lorenz Räber, Masanori Taniwaki, Serge Zaugg, Henning Kelbæk, Marco Roffi, Lene Holmvang, Stephane Noble, Giovanni Pedrazzini, Aris Moschovitis, Thomas F Lüscher, Christian M Matter, Patrick W Serruys, Peter Jüni, Hector M Garcia-Garcia, Stephan Windecker, IBIS 4 (Integrated Biomarkers and Imaging Study-4) Trial Investigators (NCT00962416)

    150 Citationer (Scopus)

    Abstract

    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.

    OriginalsprogEngelsk
    TidsskriftEuropean Heart Journal
    Vol/bind36
    Udgave nummer8
    Sider (fra-til)490-500
    Antal sider11
    ISSN0195-668X
    DOI
    StatusUdgivet - 21 feb. 2015

    Fingeraftryk

    Dyk ned i forskningsemnerne om 'Effect of high-intensity statin therapy on atherosclerosis in non-infarct-related coronary arteries (IBIS-4): a serial intravascular ultrasonography study'. Sammen danner de et unikt fingeraftryk.

    Citationsformater