Impact of High-dose Statin on Plaque Morphology

Article

Statins are clinically proven to improve CV outcomes--a new study offers insight into the mechanisms at work on arterial plaque.

Kini AS, Vengrenyuk Y, Shameer K, et al. Intracoronary imaging, cholesterol efflux, and transcriptomes after intensive statin treatment: The YELLOW II study. J Am Coll Cardiol. 2016; DOI: 10.1016/j.jacc.2016.10.029

 

Past imaging studies suggest statins may impact plauqe biology by reducing atheroma volume and lipid content, and increasing fibrous core cap thickness; high dose statins may have a more potent effect.

 

YELLOW II study evaluated changes in obstructive plaques looking at fibrous cap thickness, lipid content, changes in gene expression, cholesterol efflux, macrophage migration and HDL functionality.

 

 

Results: There was an independent association between fibrous cap thickening and improved cholesterol efflux capacity which could suggest that intensive statin therapy supports plaque stabilization.

 

 

The authors note that the observed changes appear to be independent of changes in plaque lipid content or in serum cholesterol. 

 

Among study limitations, there was no evaluation of important confounders including smoking, alcohol consumption, exercise, diet.

 

Take-home points: Eight weeks of high-dose rosuvastatin resulted in decreases prevalence of thin-cap fibroatheroma, increased minimal fibrous cap thickness, increased cholesterol efflux, and expression of genes involved in cholesterol metabolism, inflammation, matrix degradation, cholesterol regulation, statin metabolism.

Related Videos
A panel of 5 cardiovascular experts
A panel of 5 cardiovascular experts
Robert Rosenson, MD | Credit: Cura Foundation
Video 2 - "Lessons from EXPLORER-HCM: Unveiling CMIs' Potential in oHCM Treatment "
Video 1 - "Novel Cardio Myosin Inhibitors Targeting Obstructive Hypertrophic Cardiomyopathy's Root Cause "
A panel of 5 cardiovascular experts
A panel of 5 cardiovascular experts
Heart Failure Treatment Outcomes and Contraindications
Patient Involvement in Advanced HF Treatment, with Ashley Malliett, DMSc, MPAS, PA-C
Tailoring Chest Pain Diagnostics to Patients, with Kyle Fortman, PA-C, MBA
© 2024 MJH Life Sciences

All rights reserved.