title: Influence of high-dose lipid lowering treatment compared to low-dose lipid lowering treatment on plaque composition assessed by intravascular ultrasound virtual histology in patients with ST-segment elevation acute myocardial infarction: the VIRHISTAMI trial.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effect of low-dose versus high-dose rosuvastatin therapy on the necrotic core (NC) content in coronary plaques of angiographic non-significant lesions as assessed by intravascular ultrasound - virtual histology.
  
  
  RESULTS
  Eighty-seven statin-naive patients with ST-segment elevation myocardial infarction (STEMI) were randomised to 5 mg or 40 mg rosuvastatin. The volume of each plaque component (necrotic core, fibrous tissue, fibro-fatty, and dense calcium) was assessed at baseline and after 12 months of follow-up. Baseline low-density lipoprotein (LDL) cholesterol level was reduced by 31.8% in the low-dose group (from 3.1±0.7 mmol/l to 2.0±0.4 mmol/l, p<0.001) vs. 49.0% in the high-dose group (from 3.1±1.0 mmol/l to 1.6±0.7 mmol/l, p<0.001) (p=0.001 between groups). The plaque component necrotic core was reduced by 7.6% in the low-dose group (44.6±38.2 mm3 vs. 41.2±40.3 mm3, p=0.29) compared to 14.2% in the high-dose group (47.4±38.2 mm3 vs. 40.7±34.4 mm3, p=0.003) (p=0.38 between groups).
  
  
  CONCLUSIONS
  In statin-naive patients with STEMI, rosuvastatin therapy for 12 months resulted in significant reduction in LDL-cholesterol; however, a significant decrease in necrotic core volume was only seen in the high-dose group.
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark. rasmusegede@hotmail.com
authors.forename: Rasmus
authors.initials: R
authors.lastname: Egede
authors.forename: Lisette Okkels
authors.initials: LO
authors.lastname: Jensen
authors.forename: Henrik Steen
authors.initials: HS
authors.lastname: Hansen
authors.forename: Knud Nørregaard
authors.initials: KN
authors.lastname: Hansen
authors.forename: Anders
authors.initials: A
authors.lastname: Junker
authors.forename: Per
authors.initials: P
authors.lastname: Thayssen
mesh_terms: D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000473:pathology*; D009336:Necrosis; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D011743:Pyrimidines / Q000008:administration & dosage*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage*; D018084:Ultrasonography, Interventional
chemical_list: D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium