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Three-dimensional morphological response of lipid-rich coronary plaques to statin therapy: a serial optical coherence tomography study.

ABSTRACT: Previous studies have suggested that intensive statin therapy, compared with moderate statin therapy, provided greater reduction of LDL and better protection against major cardiovascular events. However, the exact dose-dependent mechanism of plaque stabilization remains unclear. The aim of this study is to investigate the three-dimensional (3D) response of fibrous caps overlying lipid plaques to statin therapy.We applied a novel computer algorithm to investigate the fibrous cap 3D morphological change over time in patients with coronary artery disease. Patients were treated with either atorvastatin 20?mg/day (moderate intensity) or atorvastatin 60?mg/day (high intensity). Optical coherence tomography was performed at baseline, 6, and 12 months. A total of 31 lipid plaques from 21 patients were analyzed.Conventional metrics such as the minimum fibrous cap thickness change between the two treatment groups were not significantly different between the baseline and the 12-month follow-up. In contrast, the 3D metric thin cap (<80??m) surface area change between the baseline and the 12-month follow-up showed dose-dependent, significant differences between the statin treatment groups (P<0.001). 3D reconstructions of fibrous caps further indicated that fibrous caps showed diverse (scattered vs. confluent) patterns and could evolve in a complex manner.High-intensity statin therapy more effectively stabilized fibrous caps at follow-up. The new 3D algorithm provided more comprehensive and detailed information on the changes in plaque phenotype in response to statin therapy.

SUBMITTER: Wang Z

PROVIDER: S-EPMC4912393 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Three-dimensional morphological response of lipid-rich coronary plaques to statin therapy: a serial optical coherence tomography study.

Wang Zhao Z Cho Young-Seok YS Soeda Tsunenari T Minami Yoshiyasu Y Xing Lei L Jia Haibo H Aguirre Aaron A Vergallo Rocco R Lee Hang H Fujimoto James G JG Yu Bo B Jang Ik-Kyung IK

Coronary artery disease 20160801 5

<h4>Objective</h4>Previous studies have suggested that intensive statin therapy, compared with moderate statin therapy, provided greater reduction of LDL and better protection against major cardiovascular events. However, the exact dose-dependent mechanism of plaque stabilization remains unclear. The aim of this study is to investigate the three-dimensional (3D) response of fibrous caps overlying lipid plaques to statin therapy.<h4>Methods</h4>We applied a novel computer algorithm to investigate ...[more]

PMID: 27105047

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Project description:BackgroundThe risk factors for coronary and carotid plaque development are consistent. Coronary plaque rupture is a major cause of adverse cardiovascular events. Ultrasound can evaluate vulnerable carotid plaques and provide information for predicting vulnerable coronary plaques identified by optical coherence tomography (OCT). This study aimed to investigate the predictive role of non-invasive carotid ultrasound in OCT diagnosis of atherosclerotic vulnerable plaque.MethodsA total of 70 participants, including 35 patients with and 35 without vulnerable coronary plaque, were enrolled in this case-control study at Beijing Anzhen Hospital from 2016 to 2021. The data of 70 patients with suspected coronary heart disease who had undergone OCT examination during percutaneous coronary intervention (PCI) surgery and completed carotid ultrasound examination within 3 days before PCI were analyzed retrospectively. According to the OCT diagnostic criteria for vulnerable plaques, the patients were divided into the vulnerable-plaque group and the stable-plaque group. Univariate and binary logistic regression analyses assessed risk factors for vulnerable coronary plaque. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive power of carotid plaque features.ResultsThe univariate analysis demonstrated that the differences in high-sensitivity C-reactive protein levels and carotid plaque characteristics (irregular fibrous cap, heterogeneous plaque, hypoechoic plaque, plaque calcification, and a plaque thickness of greater than 3 mm) between the two groups were statistically significant. The logistic multivariate regression analysis revealed that an irregular fibrous cap of a carotid plaque [odds ratio (OR) =4.819; 95% confidence interval (CI): 1.106-22.867; P=0.048] and a hypoechoic plaque (OR =9.632; 95% CI: 2.138-43.384; P<0.05) were independent risk factors for predicting vulnerable plaques of the coronary artery.ConclusionsNoninvasive carotid ultrasound is feasible and clinically valuable for predicting vulnerable and asymptomatic coronary plaques defined by OCT. With this method, adverse events can be diagnosed and treated in advance.

Dataset Information

Three-dimensional morphological response of lipid-rich coronary plaques to statin therapy: a serial optical coherence tomography study.

Publications

Three-dimensional morphological response of lipid-rich coronary plaques to statin therapy: a serial optical coherence tomography study.

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