Changes of coronary plaque composition correlate with C-reactive protein levels in patients with ST-elevation myocardial infarction following high-intensity statin therapy.

Koskinas, Konstantinos; Zaugg, Serge; Yamaji, Kyohei; García-García, Héctor M; Taniwaki, Masanori; Klingenberg, Roland; Moschovitis, Aris; Lüscher, Thomas F; van Tits, Lambertus J; Matter, Christian M; Windecker, Stephan; Räber, Lorenz (2016). Changes of coronary plaque composition correlate with C-reactive protein levels in patients with ST-elevation myocardial infarction following high-intensity statin therapy. Atherosclerosis, 247, pp. 154-160. Elsevier 10.1016/j.atherosclerosis.2016.02.015

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Kardiologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Kardiologie

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Koskinas, Konstantinos; Zaugg, Serge; Yamaji, Kyohei; Taniwaki, Masanori; Moschovitis, Aris; Windecker, Stephan and Räber, Lorenz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0021-9150

Publisher:

Elsevier

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

01 Mar 2016 11:46

Last Modified:

11 Sep 2017 16:44

Publisher DOI:

10.1016/j.atherosclerosis.2016.02.015

PubMed ID:

26921743

Additional Information:

Koskinas and Zaugg contributed equally to this work.

Uncontrolled Keywords:

Atherosclerosis Inflammation Myocardial infarction Regression Statin

BORIS DOI:

10.7892/boris.78988

URI:

https://boris.unibe.ch/id/eprint/78988

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