Abstract 13826: Effect of Treatment with 5-Lipoxygenase Inhibitor VIA-2291 (Atreleuton) on Coronary Plaque Progression: A Serial CT Angiography Study

Abstract

Background: Statins have been shown to reduce plaque progression. Little data on plaque progression is available with anti-inflammatory agents. Production of leukotrienes by 5-lipoxygenase (5-LO) has been linked to atherosclerotic plaques and cardiovascular events. VIA-2291 is a potent and selective 5-LO inhibitor. In this study, we evaluated the effect of VIA-2291 on plaque progression using serial cardiac computed tomographic angiography (CCTA).

Methods: In a double-blinded study (clinicaltrials.gov NCT00358826), 56 patients with recent acute coronary syndrome underwent serial CCTA studies after randomization to 25, 50, or 100 mg VIA-2291 or placebo daily for 24 weeks and had interpretable baseline and follow-up studies. Plaque volume, new lesion formation and calcium scores were measured by serial contrast-enhanced CCTA, and evaluated by investigators blinded to randomized treatment assignment. The changes from baseline on coronary CT scans after 24 weeks were analyzed using conditional logistic regression analyses with baseline level of the CT outcome as covariate.

Result: 56 patients with acceptable CT scans both at baseline and 24 months were included in the final analysis. From baseline to 6-months, a significant reduction in core plaque volume, fibrofatty, fibrous and calcified plaque volume in VIA-2991 as compared to placebo, was noted (Table 1, all p≤0.01). These associations remained significant after adjustment for risk factors.

Conclusion: VIA-2291 resulted in lower plaque progression compared to placebo across different plaque subtypes on serial CCTA over 6 months.