title: Changes in coronary plaque morphology in patients with acute coronary syndrome versus stable angina pectoris after initiation of statin therapy.
abstract: OBJECTIVE
  The aim of this study was to examine coronary plaque morphology after initiation of statins and compare changes in plaque morphology in patients presenting with acute coronary syndrome (ACS) versus stable angina pectoris (SAP).
  
  
  BACKGROUND
  ACS is associated with a pan-inflammatory state, and intraplaque features of inflammation correlate with coronary plaque progression. Statins have known anti-inflammatory properties that may contribute toward their beneficial cardiovascular effects.
  
  
  METHODS
  Sixty-nine statin-naive patients (ACS, n=55; SAP, n=14) underwent baseline imaging with optical coherence tomography and intravascular ultrasound. Repeat imaging was performed at 6 and 12 months. A total of 97 nonculprit plaques were analyzed (ACS, n=74; SAP, n=23).
  
  
  RESULTS
  Fibrous cap thickness increased in both ACS and SAP patients (all P<0.001 compared with the baseline); the ACS group showed greater percent change in fibrous cap thickness at 12 months (192.8±148.9% in ACS vs. 128.2±88.7% in SAP, P=0.018). The ACS group also showed a significant decrease in plaque microvessels (44.6% at baseline vs. 26.6% at 12 months, P=0.0386).
  
  
  CONCLUSIONS
  Compared with patients with SAP, patients presenting with ACS show more favorable changes in plaque morphology after starting statin treatment. This supports a potential additive benefit of statins in the inflammatory state of ACS and reaffirms the clinical importance of statin therapy for coronary atherosclerosis.
authors.affiliation: aMassachusetts General Hospital and Harvard Medical School, Cardiology Division bMassachusetts General Hospital and Harvard Medical School, Biostatistics Center, Boston, Massachusetts, USA cKey Laboratory of Myocardial Ischemia, Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, People's Republic of China dThe First Department of Medicine, Nara Medical University, Nara eGoodman Co Ltd, Nagoya, Japan fDivision of Cardiology, Kyung Hee University, Seoul, South Korea.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Gin
authors.forename: Rocco
authors.initials: R
authors.lastname: Vergallo
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Minami
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Ong
authors.forename: Jingbo
authors.initials: J
authors.lastname: Hou
authors.forename: Haibo
authors.initials: H
authors.lastname: Jia
authors.forename: Tsunenari
authors.initials: T
authors.lastname: Soeda
authors.forename: Sining
authors.initials: S
authors.lastname: Hu
authors.forename: Shaosong
authors.initials: S
authors.lastname: Zhang
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.forename: Ik-Kyung
authors.initials: IK
authors.lastname: Jang
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D000368:Aged; D060050:Angina, Stable / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000893:Anti-Inflammatory Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors