Effect of Statin Treatment on Modifying Plaque Composition: A Double-Blind, Randomized Study

Area of Science:

• Cardiology
• Vascular Biology
• Pharmacology

Background:

• Coronary atherosclerosis progression and plaque composition changes under statin therapy remain incompletely understood.
• Investigating how statins impact the cellular and molecular makeup of atherosclerotic plaques is crucial for understanding their clinical efficacy.

Purpose of the Study:

• To elucidate the effect of rosuvastatin on modifying coronary plaque composition.
• To compare the plaque-modifying effects of high-intensity versus moderate-intensity rosuvastatin therapy.

Main Methods:

• The STABLE study was a randomized, double-blind trial involving 312 patients with fibroatheroma-containing lesions.
• Patients received either rosuvastatin 40 mg or 10 mg, with virtual histology (VH)-intravascular ultrasound (IVUS) used for plaque analysis at baseline and 12 months.
• The primary endpoint was the change in VH-defined plaque composition within the target segment.

Main Results:

• Rosuvastatin significantly decreased necrotic core (NC) volume and increased fibrofatty volume, indicating plaque stabilization.
• Total and percent atheroma volumes were reduced, while fibrous and dense calcium volumes remained unchanged.
• No significant differences in plaque composition changes were observed between high-intensity (40 mg) and moderate-intensity (10 mg) rosuvastatin groups.

Conclusions:

• Rosuvastatin therapy effectively reduces necrotic core volume and overall atheroma volume, contributing to plaque stabilization.
• Both high- and moderate-intensity rosuvastatin demonstrated similar plaque-modifying effects in this study.
• These findings underscore the role of statins in altering atherosclerotic plaque characteristics, potentially reducing cardiovascular event risk.