Abstract 10951: Serial Change in Tissue Characteristics During Plaque Regression Process by Statins-Virtual Histology Intravascular Ultrasound Evaluation
Background: Whole coronary artery treatment is very important to improve prognosis of acute coronary syndrome (ACS) after early reperfusion of culprit lesions. Early statin treatment led residual lesion plaques beyond culprit lesions to regress in ACS patients. However, precise mechanism of plaque stabilization is not well known.
Purpose: We aimed that the evaluation of the plaque composition changes in progression or regression phases by virtual histology-intravascular ultrasound (VH-IVUS) under strong statin treatment.
Method: We studied effects of statins (pitavastatin 2 mg/day or atorvastatin 10 mg/day) on stabilizing coronary plaque beyond culprit lesions in 106 ACS patients, using VH-IVUS evaluation of a non-culprit lesion at admission (baseline), at short-term (2-3 weeks) and at middle-term (8-10 months). According to the plaque volume change from baseline to middle-term IVUS evaluation, subjects were divided into 2 groups, plaque regression group (n=87) and plaque progression group (n=19).
Results: In the plaque regression group, VH-IVUS findings showed that fibro-fatty plaque composition began to decrease at short term (-11.1% vs. baseline) and further decrease at middle term (-12.2%). Fibrous composition also decreased at short (-4.6%) to middle term (-11.9%). In contrast, necrotic core composition tended rather to increase at short term (+4.3%) but then decrease below the baseline level at middle term (-7.6%). In the plaque progression group, fibro-fatty and fibrous plaque compositions gradually increased (+25.6%, +6.8% at short-term and +27.9%, +8.5% at middle-term) but necrotic core composition tended to decrease at short (-11.5%) to middle term (-14.3%).
Conclusion: In the course of coronary plaque regression by statin therapy, plaque stabilization began to decrease at early phase, being associated with transiently increased plaque necrosis. In addition, even in the cases of plaque progression, statin achieved plaque stabilization.
- © 2011 by American Heart Association, Inc.