Abstract 14689: Effects of Statin Therapy on Three-Dimensional Morphology of Fibrous Caps in Lipid Plaques: Analysis Using a Newly Developed Algorithm for OCT
Background: The exact dose-dependent mechanism of plaque stabilization with statin therapy remains unclear. The objective of this study is to compare the effects of different doses of statin therapy on 3D morphology of fibrous caps using optical coherence tomography (OCT).
Methods: Patients with coronary artery disease were randomized into two groups of treatment: atorvastatin 20 mg/day (moderate intensity) and atorvastatin 60 mg/day (high intensity), and were imaged by OCT at baseline and 12-month follow-up. A total of 31 lipid plaques from 21 patients were analyzed. Fibrous caps were quantified in 3D using a novel computer algorithm. 3D metrics provided comprehensive information on the distribution and surface area of fibrous caps in a thickness category (e.g. <80 μm). Fibrous caps were reconstructed in 3D to assess plaque vulnerability (Fig. 1).
Results: Both high and moderate intensity statin therapy increased fibrous cap thickness at follow-up. However, only high intensity statin therapy reduced thin cap (<80 μm) area significantly at follow-up. Conventional metrics such as the minimum cap thickness failed to reveal the differences between the treatment groups (Fig. 2). Instead, 3-D metrics, in particular the thin cap area change showed dose-dependent differences between the treatment groups (p<0.001). 3-D reconstructions further revealed that high intensity statin treatment induced a more rapid transition from thin to thick caps.
Conclusions: High intensity statin therapy more effectively stabilized fibrous caps. Thin cap area can be used as a better metric than minimum cap thickness for characterizing vulnerable plaque evolution.
Author Disclosures: Z. Wang: None. Y. Cho: None. T. Soeda: None. L. Xing: None. H. Jia: None. A. Aguirre: None. R. Vergallo: None. Y. Minami: None. H. Lee: None. J.G. Fujimoto: None. B. Yu: None. I. Jang: Research Grant; Significant; Medtronic, Boston Scientific, St. Jude Medical.
- © 2015 by American Heart Association, Inc.