Author + information
- Received December 10, 2009
- Revision received April 26, 2010
- Accepted May 1, 2010
- Published online July 1, 2010.
- Shigeho Takarada, MD, PhD,
- Toshio Imanishi, MD, PhD,
- Kohei Ishibashi, MD,
- Takashi Tanimoto, MD,
- Kenichi Komukai, MD,
- Yasushi Ino, MD,
- Hironori Kitabata, MD,
- Takashi Kubo, MD, PhD,
- Atsushi Tanaka, MD, PhD,
- Keizo Kimura, MD, PhD,
- Masato Mizukoshi, MD, PhD and
- Takashi Akasaka, MD, PhD⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Takashi Akasaka, Department of Cardiovascular Medicine, 811-1 Kimiidera, Wakayama 641-8509, Japan
Objectives The aim of this study was to determine the relationship between the morphological changes of nonculprit lipid-rich plaques and several clinical profiles in patients with non–ST-segment elevated acute coronary syndrome (NSTEACS).
Background Identification of coronary lesion with morphological characteristics of rupture-prone plaques is still difficult.
Methods Eighty-two consecutive patients with NSTEACS who underwent percutaneous coronary intervention were enrolled. The changes in total atheroma volume (TAV) of residual nonculprit lipid-rich plaques and the changes in the corresponding fibrous cap thickness (FCT) were assessed by intravascular ultrasound and optical coherence tomography, respectively, at baseline and after 9 months.
Results The percentage changes in TAV (mm3) of lipid-rich plaques and in the corresponding FCT (μm) over the 9-month follow-up period were 3.1 ± 11% and 15 ± 17%, respectively. There was no significant correlation between the changes in TAV and those in FCT. The change in TAV showed a significant correlation with reduction of the low-density lipoprotein/high-density lipoprotein (LDL/HDL) ratio (r = 0.42, p < 0.01). In contrast, the change in FCT showed no correlation with LDL/HDL ratio but had a significant positive correlation with changes in high-sensitivity C-reactive protein (r = 0.44, p < 0.01). Furthermore, in multivariate logistic analysis, statin use was an independent predictor of changes in well-stabilized plaques that showed both TAV reduction and FCT increase.
Conclusions The changes in TAV and FCT of coronary plaques over a 9-month observation period were related to 2 different independent factors (i.e., reduction of LDL-cholesterol and high-sensitivity C-reactive protein, respectively). Furthermore, lipid-lowering therapy with statin has the potential to stabilize these parameters by both plaque reduction and FCT.
- Received December 10, 2009.
- Revision received April 26, 2010.
- Accepted May 1, 2010.
- American College of Cardiology Foundation