title: Lipid-lowering therapy stabilizes the complexity of non-culprit plaques in human coronary artery: a quantitative assessment using OCT bright spot algorithm.
abstract: To quantitatively evaluate the change of plaque complexity with cholesterol lowering therapy. A total of 44 non-culprit plaques from 30 patients who had serial image acquisition at baseline, 6-months, and 12-months by both optical coherence tomography (OCT) and intravascular ultrasound (IVUS) were included. Patients were treated with atorvastatin 60 mg (AT60, n = 16) or 20 mg (AT20, n = 14). We applied an OCT bright spot algorithm, which identifies a variety of plaque components including macrophages. The density of bright spot was measured within the superficial 250 µm of the vessel wall. Significant reduction of bright spot density was observed from baseline to 12-months [-0.49% (-0.95, -0.20), p < 0.001], particularly during the second 6 months [first 6 months: -0.01% (-0.57, 0.60), p = 0.939; second 6 months: -0.49% (-0.98, 0.14), p < 0.001]. Although there was no significant difference at 12 months in the reduction of bright spot density between plaques with acute coronary syndrome (ACS, n = 33) and those with stable angina (n = 11) [-0.49% (-0.93, -0.19) vs. -0.39% (-1.01, -0.21), p = 0.748], a significant reduction of bright spot density during the first 6 months was observed only in plaques with ACS. There was no significant difference in the change of bright spot density between the AT60 group (n = 22) and AT20 group (n = 22) [-0.61% (-0.93, -0.34) vs. -0.41% (-0.98, -0.19), p = 0.483]. Coronary plaque complexity evaluated by a quantitative OCT algorithm significantly decreased with 12 month atorvastatin therapy irrespective of the dose and initial clinical presentation.
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, GRB 800, 55 Fruit street, Boston, MA, 02114, USA.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Minami
authors.affiliation: University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
authors.forename: Taylor
authors.initials: T
authors.lastname: Hoyt
authors.affiliation: University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Phipps
authors.affiliation: Department of Biomedical Engineering, University of Texas, 107 W Dean Keeton Street Stop, Austin, TX, 78712, USA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Milner
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, GRB 800, 55 Fruit street, Boston, MA, 02114, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Xing
authors.affiliation: Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Boston, MA, 02114, USA.
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Cardiology, The 2nd Affiliated Hospital of Harbin University, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.affiliation: University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.|Veterans Administration Health Care System, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA.
authors.forename: Marc D
authors.initials: MD
authors.lastname: Feldman
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, GRB 800, 55 Fruit street, Boston, MA, 02114, USA. IJANG@mgh.harvard.edu.|Division of Cardiology, Kyung Hee University, 23 Kyunghee-daero, Dongdaemun-gu, Seoul, 130-701, South Korea. IJANG@mgh.harvard.edu.
authors.forename: Ik-Kyung
authors.initials: IK
authors.lastname: Jang
mesh_terms: D000368:Aged; D000465:Algorithms; D000069059:Atorvastatin / Q000627:therapeutic use*; D003324:Coronary Artery Disease / 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*; D007090:Image Interpretation, Computer-Assisted; 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: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069059:Atorvastatin
keywords: Acute coronary syndrome; Optical coherence tomography; Plaque rupture; Stable coronary artery disease