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Long-term effects of maximally intensive statin therapy on changes in coronary atheroma composition: insights from SATURN.
Eur Heart J Cardiovasc Imaging. 2014 Apr; 15(4):380-8.EH

Abstract

AIMS

To evaluate the effect of long-term maximally intensive statin therapy on indices of coronary atheroma composition in a randomized trial, and how these changes relate to modifications of serum lipoproteins and systemic inflammation.

METHODS AND RESULTS

The Study of coronary Atheroma by inTravascular Ultrasound: the effect of Rosuvastatin vs. atorvastatiN (SATURN) employed serial intravascular ultrasound (IVUS) measures of coronary atheroma in patients treated with rosuvastatin 40 mg or atorvastatin 80 mg daily for 24 months. Seventy-one patients underwent serial assessment of indices of plaque composition by spectral analysis of the radiofrequency IVUS signal. Changes in low-density lipoprotein cholesterol [LDL-C; -52 (-72, -33) mg/dL, P < 0.001], C-reactive protein [CRP -0.2 (-1, 0.1) mg/L, P = 0.01], and high-density lipoprotein cholesterol [HDL-C; +2.8 (-0.3, 7.8) mg/dL, P < 0.001] were associated with regression of percent atheroma volume (PAV: -1.6 ± 3.6%, P < 0.001). A reduction in estimated fibro-fatty tissue volume accompanied atheroma regression (P < 0.001), while dense calcium tissue volume increased (P = 0.002). There were no changes in fibrous or necrotic core tissue volumes. Volumetric changes in necrotic core tissue correlated with on-treatment HDL-C (r = -0.27, P = 0.03) and CRP (r = 0.25, P = 0.03) levels. A per-lesion analysis showed a reduction in the number of pathological intimal thickening lesions (defined by ≥3 consecutive IVUS frames containing PAV of ≥40%, predominantly fibro-fatty plaque, with <10% confluent necrotic core and <10% confluent dense calcium) at follow-up (67 vs. 38, P = 0.001). Fibroatheromas and fibrotic lesions remained static in number.

CONCLUSIONS

Changes in indices of atheroma composition accompany regression of coronary atheroma with maximally intensive statin therapy, and associate with anti-inflammatory effects of statins.

CLINICALTRAILSGOV NUMBER

NCT000620542.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Puri R
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
Libby P
No affiliation info available
Nissen SE
No affiliation info available
Wolski K
No affiliation info available
Ballantyne CM
No affiliation info available
Barter PJ
No affiliation info available
Chapman MJ
No affiliation info available
Erbel R
No affiliation info available
Raichlen JS
No affiliation info available
Uno K
No affiliation info available
Kataoka Y
No affiliation info available
Tuzcu EM
No affiliation info available
Nicholls SJ
No affiliation info available

MeSH

AgedAtorvastatinBiomarkersC-Reactive ProteinCholesterol, HDLCholesterol, LDLCoronary Artery DiseaseFemaleFluorobenzenesFollow-Up StudiesHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedPlaque, AtheroscleroticPyrimidinesPyrrolesResearch DesignRisk FactorsRosuvastatin CalciumSulfonamidesTime FactorsTreatment OutcomeTunica IntimaUltrasonography, Interventional

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24448227

Clinical Trial Links

Clinical trial which this article describes

Citation

Puri, Rishi, et al. "Long-term Effects of Maximally Intensive Statin Therapy On Changes in Coronary Atheroma Composition: Insights From SATURN." European Heart Journal. Cardiovascular Imaging, vol. 15, no. 4, 2014, pp. 380-8.
Puri R, Libby P, Nissen SE, et al. Long-term effects of maximally intensive statin therapy on changes in coronary atheroma composition: insights from SATURN. Eur Heart J Cardiovasc Imaging. 2014;15(4):380-8.
Puri, R., Libby, P., Nissen, S. E., Wolski, K., Ballantyne, C. M., Barter, P. J., Chapman, M. J., Erbel, R., Raichlen, J. S., Uno, K., Kataoka, Y., Tuzcu, E. M., & Nicholls, S. J. (2014). Long-term effects of maximally intensive statin therapy on changes in coronary atheroma composition: insights from SATURN. European Heart Journal. Cardiovascular Imaging, 15(4), 380-8. https://doi.org/10.1093/ehjci/jet251
Puri R, et al. Long-term Effects of Maximally Intensive Statin Therapy On Changes in Coronary Atheroma Composition: Insights From SATURN. Eur Heart J Cardiovasc Imaging. 2014;15(4):380-8. PubMed PMID: 24448227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term effects of maximally intensive statin therapy on changes in coronary atheroma composition: insights from SATURN. AU - Puri,Rishi, AU - Libby,Peter, AU - Nissen,Steven E, AU - Wolski,Kathy, AU - Ballantyne,Christie M, AU - Barter,Phillip J, AU - Chapman,M John, AU - Erbel,Raimund, AU - Raichlen,Joel S, AU - Uno,Kiyoko, AU - Kataoka,Yu, AU - Tuzcu,E Murat, AU - Nicholls,Stephen J, Y1 - 2014/01/20/ PY - 2014/1/23/entrez PY - 2014/1/23/pubmed PY - 2015/1/21/medline KW - Atherosclerosis KW - IVUS KW - Plaque composition KW - Statins KW - Virtual Histology SP - 380 EP - 8 JF - European heart journal. Cardiovascular Imaging JO - Eur Heart J Cardiovasc Imaging VL - 15 IS - 4 N2 - AIMS: To evaluate the effect of long-term maximally intensive statin therapy on indices of coronary atheroma composition in a randomized trial, and how these changes relate to modifications of serum lipoproteins and systemic inflammation. METHODS AND RESULTS: The Study of coronary Atheroma by inTravascular Ultrasound: the effect of Rosuvastatin vs. atorvastatiN (SATURN) employed serial intravascular ultrasound (IVUS) measures of coronary atheroma in patients treated with rosuvastatin 40 mg or atorvastatin 80 mg daily for 24 months. Seventy-one patients underwent serial assessment of indices of plaque composition by spectral analysis of the radiofrequency IVUS signal. Changes in low-density lipoprotein cholesterol [LDL-C; -52 (-72, -33) mg/dL, P < 0.001], C-reactive protein [CRP -0.2 (-1, 0.1) mg/L, P = 0.01], and high-density lipoprotein cholesterol [HDL-C; +2.8 (-0.3, 7.8) mg/dL, P < 0.001] were associated with regression of percent atheroma volume (PAV: -1.6 ± 3.6%, P < 0.001). A reduction in estimated fibro-fatty tissue volume accompanied atheroma regression (P < 0.001), while dense calcium tissue volume increased (P = 0.002). There were no changes in fibrous or necrotic core tissue volumes. Volumetric changes in necrotic core tissue correlated with on-treatment HDL-C (r = -0.27, P = 0.03) and CRP (r = 0.25, P = 0.03) levels. A per-lesion analysis showed a reduction in the number of pathological intimal thickening lesions (defined by ≥3 consecutive IVUS frames containing PAV of ≥40%, predominantly fibro-fatty plaque, with <10% confluent necrotic core and <10% confluent dense calcium) at follow-up (67 vs. 38, P = 0.001). Fibroatheromas and fibrotic lesions remained static in number. CONCLUSIONS: Changes in indices of atheroma composition accompany regression of coronary atheroma with maximally intensive statin therapy, and associate with anti-inflammatory effects of statins. CLINICALTRAILSGOV NUMBER: NCT000620542. SN - 2047-2412 UR - https://www.unboundmedicine.com/medline/citation/24448227/Long_term_effects_of_maximally_intensive_statin_therapy_on_changes_in_coronary_atheroma_composition:_insights_from_SATURN_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓53 ↑1]

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