Influence of ezetimibe in addition to high-dose atorvastatin therapy on plaque composition in patients with ST-segment elevation myocardial infarction assessed by serial Intravascular ultrasound with iMap: the OCTIVUS trial*

Mikkel Hougaard, Henrik Steen Hansen, Per Thayssen, Lisbeth Antonsen, Anders Junker, Karsten Veien, Lisette Okkels Jensen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

Background The aim of this study was to examine the influence of ezetimibe in addition to atorvastatin on plaque composition in patients with first-time ST-segment Elevation Myocardial Infarction treated with primary percutaneous intervention. Methods Eighty-seven patients were randomized (1:1) to ezetimibe 10 mg or placebo in addition to Atorvastatin 80 mg. Intravascular ultrasound with iMap was performed at baseline and after 12 months in a non-infarct-related artery. Primary endpoint was change in necrotic core (NC). Secondary endpoints were total atheroma volume (TAV) and percentage atheroma volume (PAV). Results NC did not change significantly: ezetimibe group 24.9 (11.9, 51.3) mm 3 to 24.9 (15.3, 54.5) mm 3, p = 0.76, placebo group 29.4 (16.3, 78.5) mm 3 to 32.0 (16.0, 88.7) mm 3, p = 0.30, (p = 0.35 between groups). TAV was reduced in the ezetimibe group only: ezetimibe (200.0 (135.6, 311.9) mm 3 to 189.3 (126.4, 269.1) mm 3, p < 0.001) compared to placebo group (218.4 (163.5, 307.9) mm 3 to 212.2 (149.9, 394.8) mm 3, p = 0.07) (p = 0.56 between groups). PAV was reduced in the ezetimibe group only (40.1 ± 8.6% to 39.2 ± 9.0%, p = 0.036) compared to placebo group (43.3 ± 9.4% to 42.2 ± 10.7%, p = 0.07), p = 0.91 between groups. Conclusions Ezetimibe in addition to atorvastatin therapy did not influence NC content, but was associated with regression of coronary atherosclerosis.

OriginalsprogEngelsk
TidsskriftCardiovascular Revascularization Medicine
Vol/bind18
Udgave nummer2
Sider (fra-til)110-117
ISSN1553-8389
DOI
StatusUdgivet - mar. 2017

Emneord

  • Atorvastatin
  • Ezetimibe
  • IVUS
  • iMap

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