Abstract 13076: Lipid-lowering Therapy Stabilizes the Complexity of Non-culprit Plaques in Human Coronary Artery: A Quantitative Assessment Using OCT Bright Spot Algorithm
Introduction: Recent studies using optical coherence tomography (OCT) reported that statin therapy increases the thickness of fibrous cap in human coronary plaques. However, the efficacy on the stabilization of plaque complexity remains unknown.
Aim: To quantitatively evaluate the statin efficacy on the change of plaque complexity using an OCT bright spot algorithm.
Methods: From a randomized trial (NCT01023607), we identified 59 lipid-rich coronary plaques in non-culprit lesions from 40 patients who were randomized to receive atorvastatin 60mg (AT60), rosuvastatin 10mg (RT10) or atorvastatin 20mg (AT20), and had serial image acquisition at baseline, 6-month, and 12-month by time-domain OCT. We applied an OCT algorithm which is able to identify bright spots representing variety of plaque components including macrophage. The density of bright spots was measured within superficial 250μm of the vessel wall as the number of bright pixels divided by the number of pixels in each frame through the entire plaque length.
Results: Significant reduction of bright spot density was observed from baseline to 12-month, particularly during the second 6 months (Figure). All three types of statin demonstrated the marked reduction of bright spot density from the baseline to 12-month (-0.61% [-0.93, -0.34], P<0.001, -0.45% [-0.99, -0.34], P=0.001 and -0.41% [-0.98, -0.19], P<0.001, in AT60 (n=22), RT10 (n=15) and AT20 (n=22), respectively) without significant difference among the groups (P=0.76). There was no significant difference in the reduction of bright spot density from baseline to 12-month between patients with acute coronary syndrome (n=47) and those with stable angina (n=12) (-0.49% [-0.97, -0.28] vs. -0.41% [-0.89, -0.21], P=0.62).
Conclusions: Coronary plaque complexity evaluated by a quantitative OCT algorithm was significantly improved by 12-month statin therapy irrespective of the statin type and baseline clinical presentation.
Author Disclosures: Y. Minami: None. T. Hoyt: None. J. Phipps: None. T. Milner: None. L. Xing: None. B. Yu: None. M. Feldman: None. I. Jang: Research Grant; Significant; St. Jude Medical, Medtronic Corporation, Boston Scientific Corporation.
- © 2015 by American Heart Association, Inc.