Abstract 13301: Virtual Histology Findings of the Effects of Atorvastatin Treatment on Coronary Plaque Volume and Composition (The VENUS Study): FINAL RESULTS
Background: Statin induces coronary plaque regression but its effects on plaque composition are uncertain. The VENUS study is a randomized double-blinded prospective pilot study to evaluate on such effects using Virtual Histology (VH-IVUS) in non-culprit lesions.
Methods: 40 statin-naïve patients (stable angina requiring PCI) were randomized to 10mg and 40mg of atorvastatin per day for 6 months. VH-IVUS assessments of fibrous tissue (FT), fibro-fatty tissue (FFT), necrotic core (NC) and calcium were performed on the non-culprit lesions, at baseline and at 6-month. All non-intervened segments (lumen CSA ≥ 4mm2, plaque burden ≥ 20% and ≥5mm from culprit lesion) were recruited. Changes were compared by 2-sample t-tests and p≤0.05 was considered significant.
Results: Refer to Table 1. A total of 111 qualified lesions (54 vs. 57) were analyzed. Baseline findings were similar. By 6 months, both groups had reduction of plaque volume by 3.83mm±14.86mm, p=0.064 (10mg) and 6.29±15.04mm, p=0.003 (40mg). Both had FT and FFT volumes&percentages reduced, with slight increase in calcium (most p-values ≤ 0.05), with no fixed pattern of changes observed among the 2 groups. NC volume was +1.65±5.2mm (p=0.024) in 10mg and −0.58±9.57mm (p=0.647) in 40mg group. Less increase in NC% was observed in 40mg group (4.78±7.82% vs. 1.68±7.57%, p=0.037). At 6 months 5 patients in 10mg group required target lesion revascularization (TLR) (no patient in 40mg group); no other MACE was observed.
Conclusions: The current VENUS pilot study shows 6 months treatment by 10mg or 40mg of atorvastatin reduces plaque volume and induces favourable VH changes, especially in FT and FFT compositions. Importantly, higher dose of atorvastatin at 40mg slows down NC% expansion more and could result in better clinical outcomes (less TLR) than 10mg.
- Percutaneous coronary intervention
- Intravascular ultrasound/Doppler
- Interventional cardiology
- © 2010 by American Heart Association, Inc.