Changes in coronary plaque color and morphology by lipid-lowering therapy with atorvastatin: serial evaluation by coronary angioscopy.
OBJECTIVE
Changes in coronary plaque color and morphology by statin therapy were evaluated using coronary angioscopy.


BACKGROUND
Coronary plaque stabilization by statin therapy has not been clarified in humans.


METHODS
Thirty-one patients with coronary artery disease were divided into either the comparison group (n = 16) or the atorvastatin group (n = 15). Before treatment and 12 months after, the color and complexity of 145 coronary plaques were determined according to angioscopic findings. The yellow score of the plaque was defined as 0 (white), 1 (light yellow), 2 (yellow), or 3 (dark yellow), and its disrupted score was defined as 0 (smooth surface) or 1 (irregular surface) and as 0 (without thrombus) or 1 (with thrombus). In each patient, the mean yellow score and mean disrupted score were calculated.


RESULTS
Mean low-density lipoprotein cholesterol (LDL-C) decreased by 45% in the atorvastatin group, whereas an increase of 9% was seen in the comparison group. The mean yellow score decreased from 2.03 to 1.13 in the atorvastatin group, whereas it increased from 1.67 to 1.99 in the comparison group. There was a good correlation between the change in the mean yellow score and the change in LDL-C levels (r = 0.81, p < 0.0001). The change in the mean yellow score and mean disrupted score differed significantly between the two groups (p = 0.002 and p = 0.03, respectively).


CONCLUSIONS
This is the first report clarifying detailed changes in coronary plaque by statin in humans. This study indicated that lipid-lowering therapy changes plaque color and morphology and should then lead to coronary plaque stabilization.
Takano
Masamichi
M
Department of Internal Medicine, Nippon Medical School, Chiba-Hokusoh Hospital, Imba, Chiba, Japan.
Mizuno
Kyoichi
K
Yokoyama
Shinya
S
Seimiya
Koji
K
Ishibashi
Fumiyuki
F
Okamatsu
Kentaro
K
Uemura
Ryota
R
D000368:Aged; D017546:Angioscopy; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000502:physiology; D003116:Color; D003324:Coronary Artery Disease / Q000188:drug therapy*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin