Statins may have dual action on vulnerable plaque
MedWire News: Statin therapy may stabilize vulnerable atherosclerotic plaque by decreasing total atheroma volume and increasing fibrous cap thickness, a study suggests.
Reductions in total atheroma volume were associated with decreases in the ratio of low- to high-density lipoprotein (LDL/HDL) cholesterol, whereas a reduction in corresponding fibrous cap thickness was related to lowered levels of high-sensitivity C-reactive protein (hs-CRP).
Furthermore, statin use independently predicted both reduction in total atheroma volume and increases in the corresponding fibrous cap thickness, the researchers report in the Journal of the American College of Cardiology Cardiovascular Interventions.
Takashi Akasaka and colleagues from Wakayama Medical University in Japan studied 82 consecutive patients with a non-ST-elevation acute coronary syndrome (NSTEACS) who underwent percutaneous coronary intervention at their institution.
Over a period of 9 months, the change of mild to moderate coronary atheroma was analyzed using serial intravascular ultrasound and optical coherence tomography.
Changes in total atheroma volume and fibrous cap thickness of residual nonculprit lipid-rich plaques were analyzed, which the researchers say are thought to be major factors influencing plaque vulnerability.
During follow-up, total atheroma volume did not change significantly, increasing slightly by 3.1%, whereas fibrous cap thickness increased by a significant 15%. Changes in these measures did not correlate with one another.
The change in total atheroma volume showed a significant correlation with reduction of the LDL/HDL cholesterol ratio. This was not observed for fibrous cap thickness, which correlated instead with changes in hsCRP.
In multivariate logistic analysis, statin use was an independent predictor of changes in well-stabilized plaques that showed both a reduction in total atheroma volume and an increase in corresponding fibrous cap thickness.
The researchers conclude: "Statin treatment seems to be a suitable form of therapy for stabilizing vulnerable plaques by both decreasing the amount of lipid-rich plaque and increasing the fibrous cap thickness."
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By Anita Wilkinson