Abstract 10935: Aggressive Lipid-lowering Therapy With Rosuvastatin may Promote Plaque Regression and Stabilization: The Aggressive Lipid-lowering Treatment Approaches for Vulnerable Plaque In Coronary Artery With Rosuvastatin (ALTAIR) Trial
Introduction: Diminishing yellow color, evaluated by coronary angioscopy, is associated with plaque stabilization. Intravascular ultrasound (IVUS) is widely used to evaluate plaque regression.
Hypothesis: We assessed the hypothesis that aggressive lipid-lowering therapy with rosuvastatin provides effective plaque stabilization and regression.
Methods: The trial was a prospective, open-label, randomized, investigator-blinded, parallel-group comparison study. Forty-eight patients in stable angina or silent myocardial ischemia who planned to undergo elective percutaneous coronary intervention (PCI) and had yellow plaques of grade 2 or more were randomized to high-dose (Group H, 20 mg/day, n=24) or conventional-dose (Group C, 2.5 mg/day, n=24) rosuvastatin therapy for 48 weeks. Yellow plaque was graded on a 4-point scale of 0 (white) to 3 (bright yellow), and plaque volume was determined by IVUS for plaques of 5 to 15 mm. Color and volume were assessed at baseline and after 48 weeks, and findings were compared between the two dosing groups. PCI sites and plaques less than 5 mm were excluded.
Results: LDL-C decreased from 120.9±26.8 mg/dl to 61.3±17.8 mg/dl in Group H (P<0.001) and from 123.8±27.6 mg/dl to 86.8±28.3 mg/dl in Group C (mean±SD, P<0.001). The averaged yellow grade decreased from 2.0 to 1.5 in Group H (P<0.001) and from 2.0 to 1.6 in Group C (P<0.001) after 48 weeks. Plaque volume decreased significantly in Group H. No significant change was observed in Group C (Table. 1). The percent change in plaque volume was significantly larger in Group H than in Group C (P=0.005).
Conclusion: Both high-dose rosuvastatin and conventional-dose rosuvastatin stabilize plaque. For regression of plaque volume, however, high-dose rosuvastatin is more effective than conventional-dose rosuvastatin.
- © 2013 by American Heart Association, Inc.