Abstract 14645: Lower LDL-C Levels are Associated with Less Necroticlipidic Tissue in STEMI Patients
Introduction: Plaque vulnerability is characterized by amount of necrotic and lipidic tissue. Statins are believed to stabilize atherosclerotic lesions after acute event. Measurable indicators of statin effect are plasma lipid levels. We hypothesized that decrease in low density lipoprotein cholesterol (LDL-C) levels will correlate with decrease in necrolipidic tissue of the culprit lesion in ST elevation myocardial infarction (STEMI) patients.
Methods: In our study we enrolled 77 patients, presenting with STEMI who underwent primary PCI with stenting. During the PCI thrombus aspiration was done if necessary and consecutive IVUS (iMapTM, IVUS, Boston Scientific Corp., Minneapolis, MN, USA) pullback of culprit lesion were performed before and after stent implantation. IVUS catheter was advanced 10 mm beyond the culprit lesion or stent at follow-up and was pulled back to a point of 20 mm proximal to the lesion or stent at follow-up. We measured blood cholesterol level on admission and follow-up. For 56 patients clinical and angiographic follow-up with IVUS imaging for culprit vessel was performed after 296±48 days.
Results: Mean levels of LDL-C at index procedure and follow-up were 3.97±1.12mmol/l vs 2.88±1.10mmol/l, p<0.0001. We found less necrolipidic tissue in percent in proximal (27.27±10.97 vs 22.22±9.97, p=0.012) and distal segment (22.23±9.97 vs 30.52±13.82, p<0.0001) at follow-up compared with index event. In patients (n=19) with LDL-C < 2.5mmol/l at follow-up were lower amount of necrolipidic tissue at proximal segment compared with others (23.20±7.28(%) vs 29.63±12.25(%), respectively, p=0.043). Similar tendency were observed when necrolipidic tissue were compared in absolute amounts among patients with LDL-C below and above 2.5mmol/l at proximal segment at follow-up (15.93±10.01mm3 vs 24.21±17.68mm3, respectively, p=0.067). Moreover, patients which LDL-C levels decreased during follow-up (n=41) had lower percentage of necrolipidic tissue at proximal segment at follow-up compared with others (26.19±10.13(%) vs 35.64±13.84(%), p=0.036).
Conclusions: Decreased levels of LDL-C at follow-up were associated with lower amount of necrolipidic tissue at proximal segment at 10 month follow-up in STEMI patients.
- © 2012 by American Heart Association, Inc.