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EFFECTS OF STATIN THERAPY ON CORONARY PLAQUE MORPHOLOGY IN PATIENTS WITH ACUTE CORONARY SYNDROME VERSUS STABLE ANGINA PECTORIS
A208 JACC March 17, 2015 Volume 65, Issue 10S
Acute Coronary Syndromes Effects of Statin Therapy on Coronary Plaque Morphology in Patients with Acute Coronary Syndrome versus Stable Angina Pectoris Poster Contributions Poster Hall B1 Sunday, March 15, 2015, 3:45 p.m.-4:30 p.m. Session Title: Procedural, Pharmacologic and Device Therapy for ACS Abstract Category: 3. Acute Coronary Syndromes: Therapy Presentation Number: 1210-091 Authors: Rocco Vergallo, Jingbo Hou, Haibo Jia, Yoshiyasu Minami, Tsunenari Soeda, Sining Hu, Shaosong Zhang, Bo Yu, Ik-Kyung Jang, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Background: Large clinical trials demonstrated the benefit of statin therapy in both patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP). However, the vascular response to statin therapy in relation to the clinical presentation is largely unknown.
Methods: Sixty-nine patients (55 ACS, 14 SAP) from a prospective, randomized trial (NCT01023607) were included. Each patient underwent optical coherence tomography and intravascular ultrasound at baseline, 6 months, and 12 months. Non-culprit plaque features were compared between ACS and SAP groups.
Results: A total of 97 plaques were analyzed (ACS, n=74; SAP, n=23). Fibrous cap thickness (FCT) steadily increased in both ACS and SAP patients (all p<0.001) (Figure). However, the absolute increase in FCT after 12 months was significantly greater in patients with ACS than in those with SAP (108.8 ± 76.0 μm vs. 79.4 ± 63.5 μm; p=0.047). Patients with ACS showed decrease in macrophage accumulation (70.3% [baseline] vs. 52.8% [12 months]; p=0.030); however, this was not observed in patients with SAP (p=0.945). In addition, prevalence of neovascularization significantly decreased only in patients with ACS (44.6% [baseline] vs. 26.6% [12 months]; p=0.028). No changes in percent atheroma volume were noted in both groups. Conclusion: Patients with ACS showed a more favorable vascular response to statin therapy than those with SAP, including greater FCT increase, and decrease in plaque inflammation and neovascularization.
Acute Coronary Syndromes Effects of Statin Therapy on Coronary Plaque Morphology in Patients with Acute Coronary Syndrome versus Stable Angina Pectoris Poster Contributions Poster Hall B1 Sunday, March 15, 2015, 3:45 p.m.-4:30 p.m. Session Title: Procedural, Pharmacologic and Device Therapy for ACS Abstract Category: 3. Acute Coronary Syndromes: Therapy Presentation Number: 1210-091 Authors: Rocco Vergallo, Jingbo Hou, Haibo Jia, Yoshiyasu Minami, Tsunenari Soeda, Sining Hu, Shaosong Zhang, Bo Yu, Ik-Kyung Jang, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Background: Large clinical trials demonstrated the benefit of statin therapy in both patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP). However, the vascular response to statin therapy in relation to the clinical presentation is largely unknown.
Methods: Sixty-nine patients (55 ACS, 14 SAP) from a prospective, randomized trial (NCT01023607) were included. Each patient underwent optical coherence tomography and intravascular ultrasound at baseline, 6 months, and 12 months. Non-culprit plaque features were compared between ACS and SAP groups.
Results: A total of 97 plaques were analyzed (ACS, n=74; SAP, n=23). Fibrous cap thickness (FCT) steadily increased in both ACS and SAP patients (all p<0.001) (Figure). However, the absolute increase in FCT after 12 months was significantly greater in patients with ACS than in those with SAP (108.8 ± 76.0 μm vs. 79.4 ± 63.5 μm; p=0.047). Patients with ACS showed decrease in macrophage accumulation (70.3% [baseline] vs. 52.8% [12 months]; p=0.030); however, this was not observed in patients with SAP (p=0.945). In addition, prevalence of neovascularization significantly decreased only in patients with ACS (44.6% [baseline] vs. 26.6% [12 months]; p=0.028). No changes in percent atheroma volume were noted in both groups. Conclusion: Patients with ACS showed a more favorable vascular response to statin therapy than those with SAP, including greater FCT increase, and decrease in plaque inflammation and neovascularization.