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Qualitative and quantitative changes in coronary plaque associated with atorvastatin therapy
Atsushi Hirayama1, Satoshi Saito, Yasunori Ueda
1Division of Cardiology, Department of Medicine, Nihon University School of Medicine, and Department of Cardiology, The Cardiovascular Institute Hospital, Tokyo, Japan. ahirayam@med.nihon-u.ac.jp
Summary
Atorvastatin treatment reduced yellow plaque color within 28 weeks and decreased plaque volume by 80 weeks in patients with coronary artery disease. These changes suggest atorvastatin may reduce plaque vulnerability.
Area of Science:
- Cardiology
- Pharmacology
- Medical Imaging
Background:
- Coronary artery disease (CAD) management often involves addressing vulnerable plaques.
- Statins, like atorvastatin, are key in managing hypercholesterolemia.
- Understanding the impact of atorvastatin on plaque characteristics is crucial.
Purpose of the Study:
- To investigate the time-dependent effects of atorvastatin on vulnerable coronary plaques.
- To evaluate changes in plaque color and volume using angioscopy and intravascular ultrasound (IVUS).
Main Methods:
- Fifty-seven hypercholesterolemic CAD patients received atorvastatin (10-20 mg/day) for 80 weeks.
- Serial angioscopy assessed plaque yellow color intensity (0-5 grades).
- Intravascular ultrasound (IVUS) measured atheroma volume in selected plaque segments.
Main Results:
- Angioscopy showed a significant decrease in mean yellow plaque grade from 1.5 to 1.1 at 28 weeks (P=0.012) and 1.2 at 80 weeks (P=0.024).
- IVUS revealed a significant reduction in atheroma volume: -8.3% at 28 weeks (P<0.001) and -17.8% at 80 weeks (P<0.001).
Conclusions:
- Atorvastatin treatment leads to early reduction in plaque yellow color, indicating decreased vulnerability.
- Subsequent plaque regression in volume was observed via IVUS.
- Combined angioscopy and IVUS findings suggest atorvastatin cumulatively reduces plaque vulnerability.
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