title: Effect of atorvastatin therapy on fibrous cap thickness in coronary atherosclerotic plaque as assessed by optical coherence tomography: the EASY-FIT study.
abstract: BACKGROUND
  The detailed mechanism of plaque stabilization by statin therapy is not fully understood.
  
  
  OBJECTIVE
  The aim of this study was to assess the effect of lipid-lowering therapy with 20 mg/day of atorvastatin versus 5 mg/day of atorvastatin on fibrous cap thickness in coronary atherosclerotic plaques by using optical coherence tomography (OCT).
  
  
  METHODS
  Seventy patients with unstable angina pectoris and untreated dyslipidemia were randomized to either 20 mg/day or 5 mg/day of atorvastatin therapy. OCT was performed to assess intermediate nonculprit lesions at baseline and 12-month follow-up.
  
  
  RESULTS
  Serum low-density lipoprotein cholesterol level was significantly lower during therapy with 20 mg/day compared with 5 mg/day of atorvastatin (69 mg/dl vs. 78 mg/dl; p = 0.039). The increase in fibrous cap thickness was significantly greater with 20 mg/day compared with 5 mg/day of atorvastatin (69% vs. 17%; p < 0.001). The increase in fibrous cap thickness correlated with the decrease in serum levels of low-density lipoprotein cholesterol (R = -0.450; p < 0.001), malondialdehyde-modified low-density lipoprotein (R = -0.283; p = 0.029), high-sensitivity C-reactive protein (R = -0.276; p = 0.033), and matrix metalloproteinase-9 (R = -0.502; p < 0.001), and the decrease in grade of OCT-derived macrophages (R = -0.415; p = 0.003).
  
  
  CONCLUSIONS
  Atorvastatin therapy at 20 mg/day provided a greater increase in fibrous cap thickness in coronary plaques compared with 5 mg/day of atorvastatin. The increase of fibrous cap was associated with the decrease in serum atherogenic lipoproteins and inflammatory biomarkers during atorvastatin therapy. (Effect of Atorvastatin Therapy on Fibrous Cap Thickness in Coronary Atherosclerotic Plaque as Assessed by Optical Coherence Tomography: The EASY-FIT Study; NCT00700037).
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Komukai
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ozaki
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Shigeho
authors.initials: S
authors.lastname: Takarada
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okumoto
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Shiono
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Orii
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shimamura
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ueno
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamano
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Hirata
authors.initials: H
authors.lastname: Kumiko
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Akagi
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan. Electronic address: akasat@wakayama-med.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000032:analysis; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D004305:Dose-Response Relationship, Drug; D050171:Dyslipidemias / Q000188:drug therapy; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008077:Lipoproteins, LDL / Q000097:blood; D008264:Macrophages / Q000378:metabolism; D008297:Male; D008315:Malondialdehyde / Q000031:analogs & derivatives / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage*; D041623:Tomography, Optical Coherence
chemical_list: D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL; D011758:Pyrroles; C569869:malondialdehyde-low density lipoprotein, human; D008315:Malondialdehyde; D002097:C-Reactive Protein; D000069059:Atorvastatin; D020780:Matrix Metalloproteinase 9
keywords: atherosclerosis; macrophage; statin therapy; vulnerable plaque