Influence of high-dose lipid lowering treatment compared to low-dose lipid lowering treatment on plaque composition assessed by intravascular ultrasound virtual histology in patients with ST-segment elevation acute myocardial infarction: the VIRHISTAMI trial

Rasmus Egede, Lisette Okkels Jensen, Henrik Steen Hansen, Knud Nørregaard Hansen, Anders Junker, Per Thayssen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

Aims: The aim of this study was to evaluate the effect of low-dose versus high-dose rosuvastatin therapy on the necrotic core (NC) content in coronary plaques of angiographic non-significant lesions as assessed by intravascular ultrasound - virtual histology. Methods and results: Eighty-seven statin-naive patients with ST-segment elevation myocardial infarction (STEMI) were randomised to 5 mg or 40 mg rosuvastatin. The volume of each plaque component (necrotic core, fibrous tissue, fibro-fatty, and dense calcium) was assessed at baseline and after 12 months of follow-up. Baseline low-density lipoprotein (LDL) cholesterol level was reduced by 31.8% in the low-dose group (from 3.1±0.7 mmol/l to 2.0±0.4 mmol/l, p<0.001) vs. 49.0% in the high-dose group (from 3.1±1.0 mmol/l to 1.6±0.7 mmol/l, p<0.001) (p=0.001 between groups). The plaque component necrotic core was reduced by 7.6% in the low-dose group (44.6±38.2 mm 3 vs. 41.2±40.3 mm 3, p=0.29) compared to 14.2% in the high-dose group (47.4±38.2 mm 3 vs. 40.7±34.4 mm 3, p=0.003) (p=0.38 between groups). Conclusions: In statin-naive patients with STEMI, rosuvastatin therapy for 12 months resulted in significant reduction in LDL-cholesterol; however, a significant decrease in necrotic core volume was only seen in the high-dose group. (Clinicaltrials.gov Identifier: NCT01058915).

OriginalsprogEngelsk
TidsskriftEuroIntervention
Vol/bind8
Udgave nummer10
Sider (fra-til)1182-1189
ISSN1774-024X
DOI
StatusUdgivet - feb. 2013

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