Influence of different lipid-lowering strategies on plaque volume and plaque composition in patients with coronary artery disease: role of intravascular ultrasound imaging.
Lipid-lowering therapy has a significant impact on the prognosis and clinical course of coronary artery disease (CAD). Slowdown of plaque progression and plaque stabilization are the major cardiac goals of any lipid-lowering strategy. Until now, intravascular ultrasound imaging (IVUS) has been the only in vivo imaging modality which allows serial analysis of plaque burden and plaque composition on a volumetric basis. Several serial IVUS studies have shown that chronic statin therapy could decrease or even halt plaque growth. Moreover, aggressive lipid-lowering therapy using statins changes plaque composition over time. There is evidence that changes in plaque composition might explain the positive prognostic impact of statin therapy in patients with CAD. Beyond clinical endpoint studies, serial volumetric IVUS studies will become the standard to prove the efficacy of new lipid-lowering strategies in the future.
Charité-Campus Virchow-Klinikum, Universitatsmedizin Berlin, Berlin, Germany. wolfgang.bocksch@charite.de
Wolfgang
W
Bocksch
Suzanne
S
Fateh-Moghadam
Sonja
S
Huehns
Michael
M
Schartl
D000101:Acetyl-CoA C-Acetyltransferase / Q000037:antagonists & inhibitors; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D018450:Disease Progression; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D018084:Ultrasonography, Interventional
D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D004791:Enzyme Inhibitors; D000960:Hypolipidemic Agents; D000101:Acetyl-CoA C-Acetyltransferase