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Rupture of lipid core plaque (LCP) is central to the pathology of an acute coronary syndrome (ACS). Intracoronary near-infrared spectroscopy (NIRS) has been shown to identify lipid core plaque (LCP) in patients undergoing coronary angiography (CA) in ACS. Studies using NIRS have shown that acute, intensive statin therapy reduces lipid core burden index (LCBI), a surrogate for lipid content in LCP. We aimed to determine if chronic long term statin use affects lipid content of LCP as measured by NIRS.
Forty-seven consecutive patients undergoing CA and NIRS with intravascular ultrasonography for at least one obstructive lesion were included. Lipid core burden index, LCBI divided by the length of scanned artery LCBI/L and the MaxLCBI 4mm (maximum value of LCBI for any of the 4-mm segment) were obtain from the scan of the three vessel except the left main and stented segment. Baseline patient characteristics and medication use was recorded. The patients receiving long-term treatment by statin before hospitalization (n=28) were compared with those without (n=19).
Patients had a mean age of 64.4 years with a prevalence of men (70.2%), diabetic (40.4%), hypercholesterolemia (89%) and smoking history (10%). In the group receiving statin, 10 patients had Atorvastatin (10 to 80 mg), 10 Rosuvastatin (5 to 40 mg) and 8 Simvastatin (10 to 40 mg). No significant difference was found for all NIRS's parameters in the both groups.
|Group statin (n=28)||Group without statin (n=19)||P|
|MaxLCBI 4mm (average)||397.46||443.63||0.31|
Although the intensive statin therapy decreases the LCBI, the presence of statin with usual doses before performing NRIS does not appear to predict the result of LCBI. The control by spectroscopy in the same patient on the occasion of new angiography after statin dose optimization should be a good way for assesses its risk of ACS.