title: Effects of intensive lipid-lowering therapy on coronary plaques composition in patients with acute myocardial infarction: Assessment with serial coronary CT angiography.
abstract: BACKGROUND
  Statins have been shown to possess favourable effects on the cardiovascular system with stabilization of the vulnerable plaque. We sought to assess the effects of early aggressive statin treatment on plaque composition in patients with acute myocardial infarction (AMI), using serial assessment with coronary CT-angiography (CTA).
  
  
  METHODS
  In a prospective randomized blinded endpoint trial patients with AMI were randomized to an intensive lipid lowering treatment receiving statin loading with 80 mg rosuvastatin followed by 40 mg daily or standard statin therapy according to current guidelines. Patients were assessed with CTA at baseline and after 12 months with evaluation of plaque volume and composition.
  
  
  RESULTS
  In total, 140 patients with AMI were randomized and plaque composition was assessed in 96 patients. In the intensive care group LDL-level was median 1.3 [0.9; 1.5] mmol/l at 12 months follow-up and 2.0 [1.7; 2.4] mmol/l in the usual care group, p < 0.001. Plaque volume increased over 12 months with 43.5 (±225.8) mm(3) in the intensive care group and 19.1 (±190.2) mm(3) in the usual care group, p = 0.57. Plaque composition changed over 12 months with an increase in total dense calcium volume by 11.1 (±39.6) mm(3), corresponding to a 23% increase, in the intensive care group and a decreased by -0.4 (±26.6) mm(3) in the usual care group, p < 0.001. Necrotic core volume increased 26.8 (±122.1) mm(3) in the intensive care group and 25.2 (±80.1) mm(3) in the usual care group, p = 0.94.
  
  
  CONCLUSIONS
  Early aggressive lipid lowering therapy significantly increases dense calcium volume in patients with AMI.
authors.affiliation: Department of Medical Research, OUH/Svendborg Hospital, Denmark. Electronic address: sorenauscher@sol.dk.
authors.forename: Søren
authors.initials: S
authors.lastname: Auscher
authors.affiliation: Department of Medical Research, OUH/Svendborg Hospital, Denmark.
authors.forename: Laurits
authors.initials: L
authors.lastname: Heinsen
authors.affiliation: Department of Cardiology and Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Koen
authors.initials: K
authors.lastname: Nieman
authors.affiliation: Department of Medical Research, OUH/Svendborg Hospital, Denmark.
authors.forename: Kristina Høeg
authors.initials: KH
authors.lastname: Vinther
authors.affiliation: Department of Medical Research, OUH/Svendborg Hospital, Denmark.
authors.forename: Brian
authors.initials: B
authors.lastname: Løgstrup
authors.affiliation: Department of Cardiology, Odense University Hospital, Denmark.
authors.forename: Jacob Eifer
authors.initials: JE
authors.lastname: Møller
authors.affiliation: Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Broersen
authors.affiliation: Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Kitslaar
authors.affiliation: Department of Medical Research, OUH/Svendborg Hospital, Denmark.
authors.forename: Jess
authors.initials: J
authors.lastname: Lambrechtsen
authors.affiliation: Department of Medical Research, OUH/Svendborg Hospital, Denmark.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Egstrup
mesh_terms: D000368:Aged; D002118:Calcium / Q000737:chemistry; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D003422:Critical Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000188:drug therapy; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D015588:Observer Variation; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011446:Prospective Studies; D000068718:Rosuvastatin Calcium / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D000068718:Rosuvastatin Calcium; D002118:Calcium
keywords: Acute myocardial infarction; Coronary CTA; Coronary plaque; Statins