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| The Effects of Pitavastatin on Regression and Compositional Changes of Plaque in Patients with Acute Myocardial Infarction: Virtual Histology-Intravascular Ultrasound Study |
| 1전남대학교병원, 2건양대학교병원, 3중앙대학교병원, 4계명의대 동산의료원, 5가천의대 길병원, 6고려의대 구로병원, 7대구카톨릭대학교병원, 8분당서울대학교병원, 9부산한서병원, 10원광대학교병원 |
| 홍영준1, 배장호2, 김상욱3, 허승호4, 정명호1, 안영근1, 안태훈5, 나승운6, 김기식7, 채인호8, 김종현9, 오석규10 외 Livalo in Acute Myocardial Infarction Study (LAMIS) 연구자 |
Background: There are very limited data regarding the effect of pitavastatin (Livalo) on regression and compositional changes of plaque in acute myocardial infarction (AMI) patients.
Objectives: We used serial virtual histology-intravascular ultrasound (VH-IVUS) to assess the efficacy of pitavastatin (dosage: 2mg/day) on plaque regression and compositional changes in non-intervened non-significant lesions in AMI patients who were enrolled in LivaloÒ in Acute Myocardial Infarction Study (LAMIS).
Methods: A total of 50 lesions in 50 patients were evaluated using serial [baseline and follow-up (mean 7.7 months)] VH-IVUS analysis retrospectively. Efficacy parameters included changes in percent atheroma volume and plaque composition.
Results: Low density lipoprotein-cholesterol (LDL-C) and high sensitivity C-reactive protein (hs-CRP) levels reduced from 123±34 mg/dL to 86±20 mg/dL (30% decrease, p<0.001) and from 0.89±1.45 mg/dL to 0.23±0.41 mg/dL (74% decrease, p<0.001). Plaque was regressed in 64% of the lesions and percent atheroma volume was decreased from baseline to follow-up (Δ=-0.2%, p=0.014). Absolute (Δfibrotic; +1.50±8.19 mm3, p=0.024, Δfibro-fatty; +1.08±7.65 mm3, p=0.005, Δdense calcium; +0.38±2.78 mm3, p=0.005, Δnecrotic core; -0.66±5.58 mm3, p=0.002) and relative necrotic core volumes (Δ%fibrotic; +2.3±8.5%, p=0.002, Δ%fibro-fatty; -0.5±7.2%, p=0.017, Δ%dense calcium; +0.4±4.9%, p=0.018, Δ%necrotic core; -2.2±7.5%, p=0.001) were decreased effectively from baseline to follow-up. Follow-up LDL-C did not correlate with changes (Δ) of absolute and relative plaque components, however, follow-up hs-CRP correlated with changes (Δ) of absolute and relative necrotic core volumes (r=0.475, p=0.026, and r=0.434, p=0.043, respectively).
Conclusions: Usual dose of pitavastatin (2mg/day) decreased LDL-C and CRP levels effectively, and it had effects on plaque regression and compositional change in non-culprit, non-intervened segments in AMI patients in LAMIS. Not follow-up LDL-C but follow-up hs-CRP was associated with changes of plaque components by statin treatment in AMI patients.
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