Early Intervention With Rosuvastatin Decreases the Lipid Components of the Plaque in Acute Coronary Syndrome - Analysis Using Integrated Backscatter IVUS (ELAN Study)
Early Intervention With Rosuvastatin Decreases the Lipid Components of the Plaque in Acute Coronary Syndrome - Analysis Using Integrated Backscatter IVUS (ELAN Study)
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DOI：
10.1253/circj.cj-10-0600
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发表时间：
2011-03-01
影响因子：
3.3
通讯作者：
Ikeda, Uichi
中科院分区：
文献类型：
--
作者：
Otagiri, Kyuhachi;Tsutsui, Hiroshi;Ikeda, Uichi
背景资料：最近，使用背向散射积分血管内超声（IB-IVUS）分析冠状动脉斑块特征已成为可能。本研究的目的是使用这种方式来评估瑞舒伐他汀的早期干预对急性冠状动脉综合征（ACS）中非罪犯斑块的体积和组织特征的影响。方法和结果：ACS患者在经皮冠状动脉介入治疗后接受了IB-IVUS，并给予瑞舒伐他汀。6个月后记录随访IB-IVUS。我们分析了这些患者的斑块负荷和组织特征的变化。根据IB-IVUS将斑块成分分为钙化、纤维和脂质。我们对20例ACS患者进行了综合分析。他汀类药物治疗后，低密度脂蛋白胆固醇水平从117 +/- 34 mg/dl显著降低至73 +/- 19 mg/dl（P < 0.001）。比较基线图像和随访图像，发现斑块负荷从98.4 ± 42.1 mm（3）/10 mm显著降低至80.2 ± 35.8 mm（3）/10 mm脂质体积从44.1 ± 29.6 mm（3）/10 mm增加到28.6 ± 17.8 mm（3）/10 mm（P < 0.001）。对于%脂质体积，随访时的减少率与其基线值显著相关（r=-0.498，P=0.024）。结论：ACS患者早期瑞舒伐他汀干预可显著减少6个月内的非罪犯斑块。这种消退主要是由于斑块的脂质成分减少。(Circ J 2011; 75：633-641）
Background: It has recently become possible to analyze coronary plaque characteristics by using integrated backscatter intravascular ultrasound (IB-IVUS). The aim of this study was to use this modality to evaluate the impact of early intervention with rosuvastatin on both the volume and tissue characteristics of non-culprit plaques in acute coronary syndrome (ACS).Methods and Results: Patients with ACS underwent IB-IVUS after percutaneous coronary intervention procedure and were administered rosuvastatin. Follow-up IB-IVUS was recorded 6 months later. We analyzed the changes in plaque burden and tissue characteristics in these patients. Plaque components were classified as calcified, fibrous, and lipid according IB-IVUS. We comprehensively analyzed 20 ACS patients. The low-density lipoprotein-cholesterol levels decreased significantly from 117 +/- 34 mg/dl to 73 +/- 19 mg/dl (P < 0.001) after statin therapy. Comparing the baseline images with the follow-up ones revealed a significant reduction in the plaque burden from 98.4 +/- 42.1 mm(3)/10 mm to 80.2 +/- 35.8 mm(3)/10 mm (P < 0.001) and in the lipid volume from 44.1 +/- 29.6 mm(3)/10 mm to 28.6 +/- 17.8 mm(3)/10 mm (P < 0.001). With respect to the % lipid volume, the reduction rate at follow-up showed a significant correlation with its baseline value (r=-0.498, P=0.024).Conclusions: Early intervention with rosuvastatin in ACS patients enabled significant reduction of the non-culprit plaque during 6 months. This regression was mainly due to the decrease in the lipid component of the plaque. (Circ J 2011; 75: 633-641)