Impact of long-term statin treatment on coronary plaque composition at angiographically severe lesions: A nonrandomized study of the history of long-term statin treatment before coronary angioplasty.

摘要

Background: Studies have found an association between treatment with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ("statins") and reductions in procedure-related complications in percutaneous coronary intervention (PCI). Objective: This study investigated the effects of long-term statin treatment before elective PCI on coronary plaque composition at the angiographically severe target stenotic lesions. Methods: This nonrandomized, observational study was conducted at Nagoya University Hospital, Nagoya, Japan. Data were collected from the electronic medical records of patients with stable angina pectoris who underwent PCI guided by intravascular ultrasound (IVUS). Patients were stratified into 2 groups: those who received long-term statin treatment for >/=6 months before PCI (statin group) and those who did not (nonstatin group). The tissue characteristics of the coronary plaque at each target stenotic site were analyzed using 3-dimensional integrated backscatter IVUS immediately before PCI. Results: Data from 100 patients were included (91 men, 9 women; mean [SD] age, 67 [10] years; statin group, 44 patients; nonstatin group, 56). The clinical characteristics of the 2 groups were not significantly different, with the exception of the prevalence of hyperlipidemia (statin vs nonstatin, 100% vs 51.8%; P < 0.001). There were no significant between-group differences in serum lipid profiles. The statin group had a significantly greater mean (SD) percentage decrease in lipid volume (28.7% [10.0%] vs 34.7% [9.8%]; P = 0.003) and a significantly greater increase in fibrous volume (66.5% [8.5%] vs 60.9% [8.6%]; P = 0.001) compared with the nonstatin group. Conclusion: This study found a significant difference in lipid and fibrous volumes in angiographically severe coronary stenotic lesions in these patients with stable angina who received long-term statin treatment before PCI versus those who did not.