Integrated Biomarker and Imaging Study 3 (IBIS-3) to assess the ability of rosuvastatin to decrease necrotic core in...

Area of Science:

• Cardiology
• Pharmacology
• Medical Imaging

Background:

• Statins are crucial for reducing cardiovascular events.
• Their direct impact on coronary plaque composition requires further investigation.
• Understanding plaque changes is key to refining lipid-lowering therapies.

Purpose of the Study:

• To mechanistically evaluate the effect of high-intensity rosuvastatin on coronary plaque composition.
• To assess changes in necrotic core (NC) volume and lipid core burden index (LCBI).

Main Methods:

• Prospective, single-centre study (IBIS-3) involving patients with stable angina or acute coronary syndrome.
• Serial radiofrequency intravascular ultrasound (RF-IVUS) and near-infrared spectroscopy (NIRS) imaging.
• Assessed NC volume and LCBI in non-stenotic segments over 12 months with high-dose rosuvastatin (40 mg daily).

Main Results:

• Low-density lipoprotein cholesterol decreased by 30% during follow-up.
• No significant change in absolute NC volume (p=0.074).
• Significant reduction in NC percentage of total plaque volume (-1.4%, p=0.006) and a neutral effect on LCBI.

Conclusions:

• One-year high-intensity rosuvastatin therapy showed a neutral effect on NC and LCBI in non-stenotic segments with low atheroma burden.
• Observed regression in NC volume and LCBI in highest baseline quartiles warrants further hypothesis-generating research.
• Findings suggest potential plaque stabilization despite neutral volumetric changes.