title: Is age an important factor for vascular response to statin therapy? A serial optical coherence tomography and intravascular ultrasound study.
abstract: OBJECTIVE
  Age-related structural and functional changes in vessel wall may affect the time course of vascular response to statin therapy. In this study, we sought to compare the response of lipid-rich plaque to statin therapy in elderly versus younger patients using optical coherence tomography and intravascular ultrasound.
  
  
  METHODS
  Sixty-nine patients who underwent serial optical coherence tomography and intravascular ultrasound at the time point of baseline, 6, and 12 months were divided into two groups according to median age: group A (age<57 years, n=35) and group B (age≥57 years, n=34). Patients were treated with intensive (atorvastatin 60 mg/day) or moderate (atorvastatin 20 mg/day or rosuvastatin 10 mg/day) statin therapy.
  
  
  RESULTS
  A continuous increase in fibrous-cap thickness (FCT) from baseline to 12 months was observed in both groups (P<0.001, <0.001, respectively). Intensive statin induced greater percent change in FCT at 12 months than moderate statin in group B (P=0.020), but not in group A (P=0.251). Mean lipid arc decreased significantly at 12 months in two groups (P<0.001, <0.001, respectively), and this response was delayed for 6 months (P=0.403) and began to decrease during the second 6 months (P<0.001) in group B. Normalized total atheroma volume decreased significantly in group A (P<0.001), but not in group B (P=0.349).
  
  
  CONCLUSIONS
  Statin therapy could stabilize lipid-rich plaque irrespective of age, and intensive statin therapy was more effective than a moderate dose of statin in increasing FCT, particularly in older patients. A delayed response of lipid content and unfavorable change in normalized total atheroma volume to statin were observed in elderly patients.
authors.affiliation: aDepartment of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China bCardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA cDivision of Cardiology, Kyung Hee University, Seoul, South Korea.
authors.forename: Jiannan
authors.initials: J
authors.lastname: Dai
authors.forename: Jingbo
authors.initials: J
authors.lastname: Hou
authors.forename: Lei
authors.initials: L
authors.lastname: Xing
authors.forename: Haibo
authors.initials: H
authors.lastname: Jia
authors.forename: Sining
authors.initials: S
authors.lastname: Hu
authors.forename: Tsunenari
authors.initials: T
authors.lastname: Soeda
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Minami
authors.forename: Daniel
authors.initials: D
authors.lastname: Ong
authors.forename: Rocco
authors.initials: R
authors.lastname: Vergallo
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: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000069059:Atorvastatin / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002681:China; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D005260:Female; D005355:Fibrosis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D000068718:Rosuvastatin Calcium / Q000008:administration & dosage*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000068718:Rosuvastatin Calcium; D002097:C-Reactive Protein; D000069059:Atorvastatin