Abstract 2542: Effect of Lipid Lowering Therapy on Progression of Coronary Fibroatheroma Evaluated by Virtual Histology Intravascular Ultrasound
Background: The aim of this study is to asses the effect of 12 month treatment with Fluvastatin (60 mg daily) on progression of fibroatheroma in a non-culprit vessel.
Methods: This prospective study was performed at 2 centers and designed to enroll 80 patients. Patients were randomized to receive lipid-lowering therapy by Fluvastatin or a lipid lowering diet. All patients with high low-density lipoprotein-cholesterol level (> 140 mg/dl) were included in the Fluvastatin group. Non-culprit vessels were imaged with a 20 MHz phased-array intravascular ultrasound (IVUS) catheter with motorized pull-back system at 0.5 mm/s. Virtual Histology-derived fibroatheroma (VHD-FA) was defined as 1) percent necrotic core area >20%; 2) percent plaque plus media cross-sectional area >40%. For each image, the area of vessel and each plaque component were calculated. At 12-month followup repeat IVUS measurements were performed.
Results: A total of 44 VHD-FAs in the Fluvastatin group and 47 VHD-FAs in the control group were detected at baseline. In the Fluvastatin group, fibrous and fibro-fatty areas are significantly decreased, necrotic core did not increase, and there was a significant reduction in atherogenic lipoproteins. In the control group, fibrous, necrotic core and dense calcium areas significantly increased (table⇓).
Conclusion: Lipid-lowering therapy with Fluvastatin prevented progression of coronary fibroatheroma.