title: Effect of atorvastatin therapy on borderline vulnerable lesions in patients with acute coronary syndrome.
abstract: BACKGROUND
  It is still controversial whether borderline lesions with a vulnerable plaque should be stented early or simply treated pharmacologically. No data exist concerning the potential effects of statin therapy on borderline vulnerable lesions in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  Fifty patients with ACS whose culprit lesions were classified as "borderline lesions" were enrolled. All patients were treated with atorvastatin (20 mg) for 12 months. Intravascular ultrasound (IVUS) was performed and matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), and high-sensitive C-reactive protein (hsCRP) levels were measured at baseline and 12-month follow-up.
  
  
  RESULTS
  At 12-month follow-up, we found: 1) IVUS revealed that minimal lumen cross-sectional area (CSA) increased but plaque/media (P&M) area and plaque burden decreased. A total of 25 soft plaques (50%) were transformed into fibrous plaques. 2) ApoB, MMP-9 and hsCRP levels decreased, but TIMP-1 level increased. 3) Stepwise multivariate linear regression analysis showed that the independent predictors for changes in P&M area/year were the decrease in MMP-9 and hsCRP levels.
  
  
  CONCLUSIONS
  Atorvastatin therapy stabilized borderline vulnerable plaques and reversed atherosclerosis progression in patients with ACS. Reversal of this progression was accompanied by a decrease in the levels of plasma MMP-9 and hsCRP. Changes in MMP-9 and hsCRP could predict vulnerable plaque stabilization.
authors.affiliation: Department of Cardiology, Guangdong Gerneral Hospital, Guangdong Provincial Cardiovascular Research Institute, Guangdong Provincial Academy of Medical Science, P. R. China.
authors.forename: Dan-Qing
authors.initials: DQ
authors.lastname: Yu
authors.forename: Shu-Guang
authors.initials: SG
authors.lastname: Lin
authors.forename: Ji-Yan
authors.initials: JY
authors.lastname: Chen
authors.forename: Ling
authors.initials: L
authors.lastname: Xue
authors.forename: Guang
authors.initials: G
authors.lastname: Li
authors.forename: Hao-Jian
authors.initials: HJ
authors.lastname: Dong
authors.forename: Ying-Ling
authors.initials: YL
authors.lastname: Zhou