High-intensity statin therapy with rosuvastatin (40 mg/day) significantly decreased percentage atheroma volume by 0.9% over 13 months in STEMI patients undergoing primary PCI.
Observational (n=103)
Does high-intensity statin therapy with rosuvastatin reduce percentage atheroma volume in STEMI patients undergoing primary PCI?
High-intensity rosuvastatin therapy for 13 months significantly reduces percentage atheroma volume in non-infarct-related arteries of STEMI patients undergoing primary PCI.
Atherosclerosis is the major disease process of cardiovascular medicine, leading to angina pectoris, myocardial infarction, and death. As stated many years ago by Rudolf Virchow, atherosclerosis is a chronic inflammation driven by cholesterol.1 With the introduction of statins2,3 guideliens from Europe and the USA4 strongly recommend their use in such patients. Controversy only exists as to whether LDL cholesterol target levels or risk-adjusted dosing should be used in their management,5 with the former advocated by the European Society of Cardiology and the latter by the American Heart Association. In a FAST TRACK manuscript entitled ‘ Effect of high-intensity statin therapy on atherosclerosis in non-infarct-related coronary arteries (IBIS-4): a serial intravascular ultrasonography study ’6 by Stefan Windecker from the University Hospital Bern, accompanied an Editorial by Peter Libby from the Brigham and Women's Hospital in Boston,7 this issue is addressed in 103 patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). The authors assessed the effects of a high-intensity statin therapy with rosuvastatin (40 mg/day) for 13 months using intravascular ultrasonography (IVUS) and radiofrequency ultrasonography (RF-IVUS), both well esthablished tools for the investigation of plaque burden, composition, and phenotype.8 The primary IVUS endpoint was the change in percentage atheroma volume. After 13 months, LDL had decreased from a median of 3.29 to 1.89 mmol/L, and HDL cholesterol had slightly increased from 1.10 to 1.20 mmol/L (both P < 0.001). In line with LDL levels, the percentage atheroma volume significantly decreased by –0.9%. Patients with regression in at least one coronary segment were more common (74%) than those without (26%). In contrast, the necrotic core was unaffected, as was the number of RF-IVUS-defined thin cap fibroatheromas. The authors conclude that in STEMI patients who underwent primary PCI, high-intensity …
Thomas F. Lüscher (Mon,) conducted a observational in Acute ST-segment elevation myocardial infarction (STEMI) (n=103). Rosuvastatin was evaluated on Change in percentage atheroma volume. High-intensity statin therapy with rosuvastatin (40 mg/day) significantly decreased percentage atheroma volume by 0.9% over 13 months in STEMI patients undergoing primary PCI.