title: Virtual histology findings and effects of varying doses of atorvastatin on coronary plaque volume and composition in statin-naive patients: the VENUS study.
abstract: BACKGROUND
  While statin induces plaque regression, its effects, particularly with different doses on plaque virtual histology composition, remain unknown.
  
  
  RESULTS
  In this prospective, randomized, double-blinded study, 40 consecutive statin-naive patients with stable angina requiring percutaneous coronary intervention (PCI) were randomized to 2 arms (20 patients each) receiving 6 months of atorvastatin 10 mg or 40 mg daily. The primary end-point was (VH-IVUS) changes from baseline to 6 months, as assessed by a core laboratory. Fifty-four VH-IVUS lesions were analyzed from the 10 mg group and 57 from the 40 mg group. Overall, plaque volume was reduced by 4.28% (-5.10±14.93 mm(3), P<0.001), absolute VH-IVUS fibrous volume by 10.54% (-4.87±10.74 mm(3), P<0.001), and relative percentage fibrous component by 3.29±7.84% (P<0.001), while relative percentage dense calcium increased by 1.50±3.08% (P<0.001), and necrotic core by 3.19±7.82% (P<0.001). Beneficial changes were more substantial in the higher dose (40 mg) group, with significantly more percentage plaque volume regression (-1.50±3.85% vs. 0.38±4.05% increase in the 10 mg group, P=0.014), less relative percentage necrotic core expansion (1.68±7.57% vs. 4.78±7.82% in the 10 mg group, P=0.037), and without occurrence of major adverse cardiac events (vs. 6 patients in the 10 mg group, P=0.020).
  
  
  CONCLUSIONS
  In statin-naive patients requiring PCI, 6 months of atorvastatin induced a significant percentage of plaque volume reduction and substantial modification of VH-IVUS composition. In addition, these effects appeared to vary with different doses of atorvastatin, showing significantly better limitation of relative percentage necrotic core expansion at a higher dose.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong. drsl@i-cable.com
authors.forename: Stephen Wai Luen
authors.initials: SW
authors.lastname: Lee
authors.forename: William Kong To
authors.initials: WK
authors.lastname: Hau
authors.forename: Shun Ling
authors.initials: SL
authors.lastname: Kong
authors.forename: Kelvin K W
authors.initials: KK
authors.lastname: Chan
authors.forename: Pak-Hei
authors.initials: PH
authors.lastname: Chan
authors.forename: Simon C C
authors.initials: SC
authors.lastname: Lam
authors.forename: Frankie C C
authors.initials: FC
authors.lastname: Tam
authors.forename: Michael K L
authors.initials: MK
authors.lastname: Wong
authors.forename: Carmen W S
authors.initials: CW
authors.lastname: Chan
authors.forename: Yui Ming
authors.initials: YM
authors.lastname: Lam
authors.forename: Hung-Fat
authors.initials: HF
authors.lastname: Tse
authors.forename: Raymond H W
authors.initials: RH
authors.lastname: Chan
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D000069059:Atorvastatin; D003324:Coronary Artery Disease / Q000473:pathology* / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000188:drug therapy* / Q000473:pathology*; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin