Impact of HMG-CoA reductase inhibitors for non-treated coronary segments

HMG-CoA reductase inhibitors (statin) have been reported to decrease coronary artery events in several angiographic studies. However, the mechanism by which statin achieve this is still unclear. The purpose of this study was to identify the effect of statin on coronary plaque using serial intravascu...

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Published inOsaka City medical journal Vol. 50; no. 2; p. 61
Main Authors Nishioka, Hiroki, Shimada, Kenei, Kataoka, Toru, Hirose, Makoto, Asawa, Koichiro, Hasegawa, Takao, Yamashita, Hajime, Ehara, Shoichi, Kamimori, Kimio, Sakamoto, Tsunemori, Kobayashi, Yoshiki, Yoshimura, Takayoshi, Yoshiyama, Minoru, Takeuchi, Kazuhide, Yoshikawa, Junichi
Format Journal Article
LanguageEnglish
Published Japan 01.12.2004
Subjects
Aged
Carotid Stenosis - diagnostic imaging
Carotid Stenosis - drug therapy
Coronary Vessels - diagnostic imaging
Coronary Vessels - drug effects
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Middle Aged
Treatment Outcome
Ultrasonography, Interventional
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Summary:HMG-CoA reductase inhibitors (statin) have been reported to decrease coronary artery events in several angiographic studies. However, the mechanism by which statin achieve this is still unclear. The purpose of this study was to identify the effect of statin on coronary plaque using serial intravascular ultrasound analysis. In this study, 48 patients with 48 lesions were divided into the prescribed group (statin group, n = 22) or the non-prescribed group (control group, n = 26) after successful coronary artery stenting. IVUS images were obtained at consecutive 5 mm segments, 5 mm from the proximal stent edge, immediately after stenting and at 6 months follow up. External elastic membrane volume (EEMV), lumen volume (LV) and plaque volume (PV) were measured using Simpson's method. The control group revealed no significant serial change in EEMV, PV, and LV during 6 months. On the other hand, the statin group revealed significant reductions of PV (35.5 +/- 12.7 mm3 vs 30.9 +/- 15.6 mm3, p = 0.001), resulting in increase of LV (47.7 +/- 19.8 mm3 vs 52.5 +/- 22.2 mm3, p = 0.003) without EEMV change (82.8 +/- 21.8 mm3 vs 83.9 +/- 25.7 mm3, p = NS). Although percent EEMV and percent LV changes showed no differences between the two groups, a larger percent PV change was observed in the statin group compared to the control group (control; 5.8 +/- 20.3% vs statin; -20.4 +/- 21.8%, p = 0.02). The results of this study suggest that statin administration for 6 months reduces coronary plaque without positive vessel remodeling.
ISSN:0030-6096