title: Changes in plaque lipid content after short-term intensive versus standard statin therapy: the YELLOW trial (reduction in yellow plaque by aggressive lipid-lowering therapy).
abstract: OBJECTIVE
  This study sought to determine the impact of short-term intensive statin therapy on intracoronary plaque lipid content.
  
  
  BACKGROUND
  Statin therapy significantly reduces the risk for thrombotic events. Whether or not these benefits are attributable to reduction in plaque lipid content remains to be properly documented in human obstructive coronary artery disease (CAD).
  
  
  METHODS
  We randomized 87 patients with multivessel CAD undergoing percutaneous coronary intervention and at least 1 other severely obstructive (fractional flow reserve [FFR] ≤0.8) nontarget lesion (NTL) to intensive (rosuvastatin 40 mg daily) or standard-of-care lipid-lowering therapy. NTLs were evaluated at baseline and after 7 weeks of therapy with FFR, near-infrared spectroscopy, and intravascular ultrasound. The primary endpoint was the change in lipid-core burden index at the 4-mm maximal segment (LCBI4mm max), wherever this occurred within the lesion.
  
  
  RESULTS
  Upon follow-up, median reduction (95% confidence interval) in LCBI4mm max was significantly greater in the intensive versus standard group (-149.1 [-210.9 to -42.9] vs. 2.4 [-36.1 to 44.7]; p = 0.01). Results remained consistent after adjustment for baseline differences in LCBI between groups and use of change in LCBI across the entire lesion as the dependent outcome.
  
  
  CONCLUSIONS
  Short-term intensive statin therapy may reduce lipid content in obstructive lesions. These hypothesis-generating findings warrant confirmation in larger studies with longer follow-up. (Reduction in YEllow Plaque by Aggressive Lipid LOWering Therapy [YELLOW]); NCT01567826).
authors: Mount Sinai School of Medicine, New York, NY, USA.
authors: Annapoorna S
authors: AS
authors: Kini
authors: Usman
authors: U
authors: Baber
authors: Jason C
authors: JC
authors: Kovacic
authors: Atul
authors: A
authors: Limaye
authors: Ziad A
authors: ZA
authors: Ali
authors: Joseph
authors: J
authors: Sweeny
authors: Akiko
authors: A
authors: Maehara
authors: Roxana
authors: R
authors: Mehran
authors: George
authors: G
authors: Dangas
authors: Gary S
authors: GS
authors: Mintz
authors: Valentin
authors: V
authors: Fuster
authors: Jagat
authors: J
authors: Narula
authors: Samin K
authors: SK
authors: Sharma
authors: Pedro R
authors: PR
authors: Moreno
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids