Early intervention with rosuvastatin decreases the lipid components of the plaque in acute coronary syndrome: analysis using integrated backscatter IVUS (ELAN study).
BACKGROUND
It has recently become possible to analyze coronary plaque characteristics by using integrated backscatter intravascular ultrasound (IB-IVUS). The aim of this study was to use this modality to evaluate the impact of early intervention with rosuvastatin on both the volume and tissue characteristics of non-culprit plaques in acute coronary syndrome (ACS).


RESULTS
Patients with ACS underwent IB-IVUS after percutaneous coronary intervention procedure and were administered rosuvastatin. Follow-up IB-IVUS was recorded 6 months later. We analyzed the changes in plaque burden and tissue characteristics in these patients. Plaque components were classified as calcified, fibrous, and lipid according IB-IVUS. We comprehensively analyzed 20 ACS patients. The low-density lipoprotein-cholesterol levels decreased significantly from 117 ± 34 mg/dl to 73 ± 19 mg/dl (P<0.001) after statin therapy. Comparing the baseline images with the follow-up ones revealed a significant reduction in the plaque burden from 98.4 ± 42.1mm(3)/10mm to 80.2 ± 35.8 mm(3)/10mm (P<0.001) and in the lipid volume from 44.1 ± 29.6 mm(3)/10mm to 28.6 ± 17.8 mm(3)/10mm (P<0.001). With respect to the % lipid volume, the reduction rate at follow-up showed a significant correlation with its baseline value (r=-0.498, P=0.024).


CONCLUSIONS
Early intervention with rosuvastatin in ACS patients enabled significant reduction of the non-culprit plaque during 6 months. This regression was mainly due to the decrease in the lipid component of the plaque.
Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Kyuhachi
K
Otagiri
Hiroshi
H
Tsutsui
Setsuo
S
Kumazaki
Yusuke
Y
Miyashita
Kazunori
K
Aizawa
Megumi
M
Koshikawa
Hiroki
H
Kasai
Atsushi
A
Izawa
Takeshi
T
Tomita
Jun
J
Koyama
Uichi
U
Ikeda
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism*; D000368:Aged; D008078:Cholesterol, LDL / Q000378:metabolism; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D005464:Fluorobenzenes / Q000494:pharmacology* / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism*; D011743:Pyrimidines / Q000494:pharmacology* / Q000627:therapeutic use; D012189:Retrospective Studies; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium