Lorenz Räber1, Konstantinos C Koskinas2, Kyohei Yamaji3, Masanori Taniwaki4, Marco Roffi5, Lene Holmvang6, Hector M Garcia Garcia7, Thomas Zanchin2, Rafaela Maldonado2, Aris Moschovitis2, Giovanni Pedrazzini8, Serge Zaugg9, Jouke Dijkstra10, Christian M Matter11, Patrick W Serruys12, Thomas F Lüscher13, Henning Kelbaek14, Alexios Karagiannis9, Maria D Radu6, Stephan Windecker2. 1. Department of Cardiology, Bern University Hospital, Bern, Switzerland. Electronic address: lorenz.raeber@insel.ch. 2. Department of Cardiology, Bern University Hospital, Bern, Switzerland. 3. Department of Cardiology, Bern University Hospital, Bern, Switzerland; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. 4. Department of Cardiology, Bern University Hospital, Bern, Switzerland; Tokorozawa Heart Center, Saitama, Japan. 5. Division of Cardiology, University Hospital Geneva, Geneva, Switzerland. 6. Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 7. MedStar Cardiovacular Research Network, MedStar Washington Hospital Center, Washington. 8. Cardiocentro, Lugano, Switzerland. 9. Clinical Trials Unit (CTU), Bern, and Institute of Social and Preventive Medicine, University of Bern, Bern Switzerland. 10. Leiden University Medical Center, Leiden, the Netherlands. 11. Department of Cardiology, Zurich University Hospital, Zurich, Switzerland. 12. International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College, London, London, United Kingdom. 13. Royal Brompton and Harefield Hospital Trust and Imperial College, London, United Kingdom. 14. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
Abstract
OBJECTIVES: This study assessed changes in optical coherence tomography (OCT)-defined plaque composition in patients with ST-elevation myocardial infarction (STEMI) receiving high-intensity statin treatment. BACKGROUND: OCT is a high-resolution modality capable of measuring plaque characteristics including fibrous cap thickness (FCT) and macrophage infiltration. There is limited in vivo evidence regarding the effects of statins on OCT-defined coronary atheroma composition and no evidence in the context of STEMI. METHODS: In the IBIS-4 (Integrated Biomarker Imaging Study-4), 103 patients underwent intravascular ultrasonography and OCT of 2 noninfarct-related coronary arteries in the acute phase of STEMI. Patients were treated with high-dose rosuvastatin for 13 months. Serial OCT imaging was available in 153 arteries from 83 patients. We measured FCT by using a semi-automated method. Co-primary endpoints consisted of the change in minimum FCT (measured in fibroatheromas) and change in macrophage line arc. RESULTS: At 13 months, median low-density lipoprotein cholesterol had decreased from 128 mg/dl to 73.6 mg/dl. Minimum FCT, measured in 31 lesions from 27 patients, increased from 64.9 ± 19.9 μm to 87.9 ± 38.1 μm (p = 0.008). Macrophage line arc decreased from 9.6° ± 12.8° to 6.4° ± 9.6° (p < 0.0001). The secondary endpoint, mean lipid arc, decreased from 55.9° ± 37° to 43.5° ± 33.5°. In lesion-level analyses (n = 191), 9 of 13 thin-cap fibroatheromata (TCFAs) at baseline (69.2%) regressed to non-TCFA morphology, whereas 2 of 178 non-TCFA lesions (1.1%) progressed to TCFAs. CONCLUSIONS: In this observational study, we found significant increase in minimum FCT, reduction in macrophage accumulation, and frequent regression of TCFAs to other plaque phenotypes in nonculprit lesions of patients with STEMI treated with high-intensity statin therapy.
OBJECTIVES: This study assessed changes in optical coherence tomography (OCT)-defined plaque composition in patients with ST-elevation myocardial infarction (STEMI) receiving high-intensity statin treatment. BACKGROUND: OCT is a high-resolution modality capable of measuring plaque characteristics including fibrous cap thickness (FCT) and macrophage infiltration. There is limited in vivo evidence regarding the effects of statins on OCT-defined coronary atheroma composition and no evidence in the context of STEMI. METHODS: In the IBIS-4 (Integrated Biomarker Imaging Study-4), 103 patients underwent intravascular ultrasonography and OCT of 2 noninfarct-related coronary arteries in the acute phase of STEMI. Patients were treated with high-dose rosuvastatin for 13 months. Serial OCT imaging was available in 153 arteries from 83 patients. We measured FCT by using a semi-automated method. Co-primary endpoints consisted of the change in minimum FCT (measured in fibroatheromas) and change in macrophage line arc. RESULTS: At 13 months, median low-density lipoprotein cholesterol had decreased from 128 mg/dl to 73.6 mg/dl. Minimum FCT, measured in 31 lesions from 27 patients, increased from 64.9 ± 19.9 μm to 87.9 ± 38.1 μm (p = 0.008). Macrophage line arc decreased from 9.6° ± 12.8° to 6.4° ± 9.6° (p < 0.0001). The secondary endpoint, mean lipid arc, decreased from 55.9° ± 37° to 43.5° ± 33.5°. In lesion-level analyses (n = 191), 9 of 13 thin-cap fibroatheromata (TCFAs) at baseline (69.2%) regressed to non-TCFA morphology, whereas 2 of 178 non-TCFA lesions (1.1%) progressed to TCFAs. CONCLUSIONS: In this observational study, we found significant increase in minimum FCT, reduction in macrophage accumulation, and frequent regression of TCFAs to other plaque phenotypes in nonculprit lesions of patients with STEMI treated with high-intensity statin therapy.
Authors: Lorenz Räber; Yasushi Ueki; Tatsuhiko Otsuka; Sylvain Losdat; Jonas D Häner; Jacob Lonborg; Gregor Fahrni; Juan F Iglesias; Robert-Jan van Geuns; Anna S Ondracek; Maria D Radu Juul Jensen; Christian Zanchin; Stefan Stortecky; David Spirk; George C M Siontis; Lanja Saleh; Christian M Matter; Joost Daemen; François Mach; Dik Heg; Stephan Windecker; Thomas Engstrøm; Irene M Lang; Konstantinos C Koskinas Journal: JAMA Date: 2022-05-10 Impact factor: 157.335
Authors: Makoto Araki; Seung-Jung Park; Harold L Dauerman; Shiro Uemura; Jung-Sun Kim; Carlo Di Mario; Thomas W Johnson; Giulio Guagliumi; Adnan Kastrati; Michael Joner; Niels Ramsing Holm; Fernando Alfonso; William Wijns; Tom Adriaenssens; Holger Nef; Gilles Rioufol; Nicolas Amabile; Geraud Souteyrand; Nicolas Meneveau; Edouard Gerbaud; Maksymilian P Opolski; Nieves Gonzalo; Guillermo J Tearney; Brett Bouma; Aaron D Aguirre; Gary S Mintz; Gregg W Stone; Christos V Bourantas; Lorenz Räber; Sebastiano Gili; Kyoichi Mizuno; Shigeki Kimura; Toshiro Shinke; Myeong-Ki Hong; Yangsoo Jang; Jin Man Cho; Bryan P Yan; Italo Porto; Giampaolo Niccoli; Rocco A Montone; Vikas Thondapu; Michail I Papafaklis; Lampros K Michalis; Harmony Reynolds; Jacqueline Saw; Peter Libby; Giora Weisz; Mario Iannaccone; Tommaso Gori; Konstantinos Toutouzas; Taishi Yonetsu; Yoshiyasu Minami; Masamichi Takano; O Christopher Raffel; Osamu Kurihara; Tsunenari Soeda; Tomoyo Sugiyama; Hyung Oh Kim; Tetsumin Lee; Takumi Higuma; Akihiro Nakajima; Erika Yamamoto; Krzysztof L Bryniarski; Luca Di Vito; Rocco Vergallo; Francesco Fracassi; Michele Russo; Lena M Seegers; Iris McNulty; Sangjoon Park; Marc Feldman; Javier Escaned; Francesco Prati; Eloisa Arbustini; Fausto J Pinto; Ron Waksman; Hector M Garcia-Garcia; Akiko Maehara; Ziad Ali; Aloke V Finn; Renu Virmani; Annapoorna S Kini; Joost Daemen; Teruyoshi Kume; Kiyoshi Hibi; Atsushi Tanaka; Takashi Akasaka; Takashi Kubo; Satoshi Yasuda; Kevin Croce; Juan F Granada; Amir Lerman; Abhiram Prasad; Evelyn Regar; Yoshihiko Saito; Mullasari Ajit Sankardas; Vijayakumar Subban; Neil J Weissman; Yundai Chen; Bo Yu; Stephen J Nicholls; Peter Barlis; Nick E J West; Armin Arbab-Zadeh; Jong Chul Ye; Jouke Dijkstra; Hang Lee; Jagat Narula; Filippo Crea; Sunao Nakamura; Tsunekazu Kakuta; James Fujimoto; Valentin Fuster; Ik-Kyung Jang Journal: Nat Rev Cardiol Date: 2022-04-21 Impact factor: 49.421