Early intervention with rosuvastatin decreases the lipid components of the plaque in acute coronary syndrome: analysis using integrated backscatter IVUS (ELAN study)

Circ J. 2011;75(3):633-41. doi: 10.1253/circj.cj-10-0600. Epub 2011 Jan 24.

Abstract

Background: It has recently become possible to analyze coronary plaque characteristics by using integrated backscatter intravascular ultrasound (IB-IVUS). The aim of this study was to use this modality to evaluate the impact of early intervention with rosuvastatin on both the volume and tissue characteristics of non-culprit plaques in acute coronary syndrome (ACS).

Methods and results: Patients with ACS underwent IB-IVUS after percutaneous coronary intervention procedure and were administered rosuvastatin. Follow-up IB-IVUS was recorded 6 months later. We analyzed the changes in plaque burden and tissue characteristics in these patients. Plaque components were classified as calcified, fibrous, and lipid according IB-IVUS. We comprehensively analyzed 20 ACS patients. The low-density lipoprotein-cholesterol levels decreased significantly from 117 ± 34 mg/dl to 73 ± 19 mg/dl (P<0.001) after statin therapy. Comparing the baseline images with the follow-up ones revealed a significant reduction in the plaque burden from 98.4 ± 42.1mm(3)/10mm to 80.2 ± 35.8 mm(3)/10mm (P<0.001) and in the lipid volume from 44.1 ± 29.6 mm(3)/10mm to 28.6 ± 17.8 mm(3)/10mm (P<0.001). With respect to the % lipid volume, the reduction rate at follow-up showed a significant correlation with its baseline value (r=-0.498, P=0.024).

Conclusions: Early intervention with rosuvastatin in ACS patients enabled significant reduction of the non-culprit plaque during 6 months. This regression was mainly due to the decrease in the lipid component of the plaque.

MeSH terms

  • Acute Coronary Syndrome / diagnostic imaging*
  • Acute Coronary Syndrome / drug therapy
  • Acute Coronary Syndrome / metabolism*
  • Aged
  • Cholesterol, LDL / metabolism
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / drug therapy
  • Coronary Artery Disease / metabolism
  • Female
  • Fluorobenzenes / pharmacology*
  • Fluorobenzenes / therapeutic use
  • Follow-Up Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Lipid Metabolism / drug effects*
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic / diagnostic imaging*
  • Plaque, Atherosclerotic / drug therapy
  • Plaque, Atherosclerotic / metabolism*
  • Pyrimidines / pharmacology*
  • Pyrimidines / therapeutic use
  • Retrospective Studies
  • Rosuvastatin Calcium
  • Sulfonamides / pharmacology*
  • Sulfonamides / therapeutic use
  • Treatment Outcome
  • Ultrasonography, Interventional

Substances

  • Cholesterol, LDL
  • Fluorobenzenes
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrimidines
  • Sulfonamides
  • Rosuvastatin Calcium