TY - JOUR T1 - Changes of coronary plaque composition correlate with C-reactive protein levels in patients with ST-elevation myocardial infarction following high-intensity statin therapy. AU - Koskinas,Konstantinos C, AU - Zaugg,Serge, AU - Yamaji,Kyohei, AU - García-García,Héctor M, AU - Taniwaki,Masanori, AU - Klingenberg,Roland, AU - Moschovitis,Aris, AU - Lüscher,Thomas F, AU - van Tits,Lambertus J, AU - Matter,Christian M, AU - Windecker,Stephan, AU - Räber,Lorenz, Y1 - 2016/02/16/ PY - 2015/09/25/received PY - 2016/02/02/revised PY - 2016/02/12/accepted PY - 2016/2/28/entrez PY - 2016/2/28/pubmed PY - 2016/12/27/medline KW - Atherosclerosis KW - Inflammation KW - Myocardial infarction KW - Regression KW - Statin SP - 154 EP - 60 JF - Atherosclerosis JO - Atherosclerosis VL - 247 N2 - OBJECTIVES: Levels of inflammatory biomarkers associate with changes of coronary atheroma burden in statin-treated patients with stable coronary artery disease. This study sought to determine changes of plaque composition in vivo in relation to high-sensitivity C-reactive protein (hs-CRP) levels in patients with ST-elevation myocardial infarction (STEMI) receiving high-intensity statin therapy. METHODS: The IBIS-4 study performed serial (baseline and 13-month), 2-vessel intravascular ultrasound (IVUS) and radiofrequency-IVUS of the non-infarct-related arteries in patients with STEMI treated with high-intensity statin therapy. The present analysis included 44 patients (80 arteries) with serial measurements of hs-CRP. RESULTS: At follow-up, median low-density lipoprotein cholesterol (LDL-C) levels decreased from 126 to 77 mg/dl, HDL-C increased from 44 to 47 mg/dl, and hs-CRP decreased from 1.6 to 0.7 mg/L. Regression of percent atheroma volume (-0.99%, 95% CI -1.84 to -0.14, p = 0.024) was accompanied by reduction of percent fibro-fatty (p = 0.04) and fibrous tissue (p < 0.001), and increase in percent necrotic core (p = 0.006) and dense calcium (p < 0.001). Follow-up levels of hs-CRP, but not LDL-C, correlated with changes in percent necrotic core (p = 0.001) and inversely with percent fibrous tissue volume (p = 0.008). Similarly, baseline-to-follow-up change of hs-CRP correlated with the change in percent necrotic core volume (p = 0.02). CONCLUSIONS: In STEMI patients receiving high-intensity statin therapy, stabilization of VH-IVUS-defined necrotic core was confined to patients with lowest on-treatment levels and greatest reduction of hs-CRP. Elevated CRP levels at follow-up may identify progression of high-risk coronary plaque composition despite intensive statin therapy and overall regression of atheroma volume. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/26921743/Changes_of_coronary_plaque_composition_correlate_with_C_reactive_protein_levels_in_patients_with_ST_elevation_myocardial_infarction_following_high_intensity_statin_therapy_ DB - PRIME DP - Unbound Medicine ER -