Effect of statin therapy on coronary fibrous-cap thickness in patients with acute coronary syndrome: assessment by optical coherence tomography study.
BACKGROUND
The thickness of coronary fibrous caps is a major determinant of vulnerable plaques. Several clinical trials have suggested that statin therapy could stabilize vulnerable plaques. Recently, optical coherence tomography (OCT) has been proposed as an effective histology-resolution imaging modality for assessing such micro-structural changes.


METHODS
Forty AMI patients with hyperlipidemia were enrolled and underwent percutaneous coronary intervention (PCI). They were divided into two groups; statin treatment group (n=23) or control group (n=17). Serial OCT analyses were performed at baseline and 9-month follow-up for a non-PCI lipid-rich plaque lesion.


RESULTS
The LDL-cholesterol level in the statin group was significantly lower than that in the control group at follow-up. Although the fibrous-cap thickness was significantly increased in both the statin treatment group (151+/-110 to 280+/-120 microm, p<0.01) and the control group (153+/-116 to 179+/-124 microm, p<0.01) during follow-up period, the degree of increase was significantly greater in the statin treatment group than in the control group (188+/-64% vs. 117+/-39%, p<0.01). Furthermore, when the patients in the statin treatment group were divided into two subgroups (fibrous-cap thickness <median and >or=median), the thin fibrous-cap group (<median) increased their thickness much more than the thick fibrous-cap group (>or=median).


CONCLUSIONS
The lipid-lowering therapy with statin for 9 months after the onset of acute myocardial infarction significantly increased the fibrous-cap thickness in patients with hyperlipidemia.
Takarada
Shigeho
S
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Imanishi
Toshio
T
Kubo
Takashi
T
Tanimoto
Takashi
T
Kitabata
Hironori
H
Nakamura
Nobuo
N
Tanaka
Atsushi
A
Mizukoshi
Masato
M
Akasaka
Takashi
T
D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D003331:Coronary Vessels / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000592:standards; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides