Effect of pitavastatin treatment on changes of plaque volume and composition according to the reduction of high-sensitivity C-reactive protein levels.
BACKGROUND
There are few data regarding the effect of statins on regression and compositional changes of plaque according to the reduction in high-sensitivity C-reactive protein (hs-CRP) levels in acute myocardial infarction (AMI) patients.


METHODS
We used serial virtual histology-intravascular ultrasound to assess the efficacy of pitavastatin (dosage: 2mg/day) on plaque regression and compositional changes according to the degree of reduction in hs-CRP levels from baseline to follow-up [≥1mg/dl (n=62) vs. <1mg/dl (n=32)] in non-intervened non-infarct related artery in AMI patients who were enrolled in the Livalo in acute myocardial infarction study (LAMIS).


RESULTS
Total atheroma and percent atheroma volumes decreased more significantly in patients with reduction in hs-CRP ≥1mg/dl compared with those with reduction in hs-CRP <1mg/dl (-1.7±12.4mm(3) vs. +2.7±7.8mm(3), p<0.015, and -0.4±3.4% vs. +0.4±4.8%, p<0.001, respectively). Absolute and %necrotic core volumes decreased more significantly in patients with reduction in hs-CRP ≥1mg/dl compared with those with reduction in hs-CRP <1mg/dl (-0.4±3.5mm(3) vs. +1.9±3.4mm(3), p=0.038, and -1.1±4.9% vs. +2.7±4.7%, p=0.016, respectively). Reduction in hs-CRP ≥1mg/dl at follow-up was the independent predictor of reduction of percent atheroma volume and %necrotic core volume at follow-up [odds ratio (OR), 2.228; 95% confidence interval (CI), 1.390-2.977, p=0.016, and OR, 2.204; 95% CI, 1.512-2.916, p=0.020, respectively].


CONCLUSIONS
Reduction in hs-CRP levels in AMI patients plays an important role in the beneficial effects of statins on the regression and compositional change of coronary plaque.
Chonnam National University Hospital, Gwangju, Republic of Korea.
Young Joon
YJ
Hong
Myung Ho
MH
Jeong
Youngkeun
Y
Ahn
Sang Wook
SW
Kim
Jang Ho
JH
Bae
Seung Ho
SH
Hur
Tae Hoon
TH
Ahn
Seung Woon
SW
Rha
Kee Sik
KS
Kim
In Ho
IH
Chae
Jong Hyun
JH
Kim
Kyeong Ho
KH
Yun
Seok Kyu
SK
Oh
D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D058226:Plaque, Atherosclerotic / Q000737:chemistry* / Q000188:drug therapy*; D011446:Prospective Studies; D011804:Quinolines / Q000627:therapeutic use*; D018084:Ultrasonography, Interventional
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011804:Quinolines; D002097:C-Reactive Protein; C108475:pitavastatin