Abstract 19081: 5-lipoxygenase Inhibitor Via-2291 (atreleuton) Reduces Inflammation and Coronary Necrotic Core Plaque and Improves Left Ventricular Function in Patients After an Acute Coronary Syndrome

Abstract

Background: The 5-lipoxygenase inhibitor VIA-2291 effectively lowers production of leukotriene metabolites. This study investigates the relations between inflammation, coronary plaque characteristics and left ventricular function in response to treatment with VIA-2291 (Atreleuton) in patients after an acute coronary syndrome (ACS).

Methods: Fifty six post-ACS patients who participated in a randomized trial evaluating the effects of VIA-2291 vs. placebo and underwent cardiac computed tomography angiography were studied. Leukotriene E4 (LTE4), high-sensitivity C-reactive protein (hs-CRP), coronary plaque volume (PV) with vulnerable characteristics (Necrotic Core) and left ventricular ejection fraction (LVEF) were measured at baseline and at 6-month follow-up. The relation of changes in LTE4, hs-CRP, PV and LVEF in response to VIA-2291 was analyzed using conditional logistic regression analyses.

Results: From baseline to 6 months, after adjustment for risk factors, significant reductions in LTE4, hs-CRP and VP, and an increase in LVEF with VIA-2991 as compared to placebo were noted (p<0.05, Table).After adjustment for risk factors, there were strong associations between the decrease in LTE4, the decrease in necrotic core PV and the increase in LVEF (Table); 71% and 79% of the variance in PV and LVEF was explained by the decrease in LTE4 in response to VIA-2991 (p<0.05). The maximum improvement in LVEF was noted with maximum decrease in LTE4 and PV.

Conclusion: This study documented a strong relation between decreases in LTE4, decreases in necrotic core coronary plaque volume and improved LV function in response to VIA-2291.