التفاصيل البيبلوغرافية
| العنوان: |
Changes of coronary plaque composition correlate with C-reactive protein levels in patients with ST-elevation myocardial infarction following high-intensity statin therapy. |
| المؤلفون: |
Koskinas, Konstantinos C.1, Zaugg, Serge2, Yamaji, Kyohei1, García-García, Héctor M.3, Taniwaki, Masanori1, Klingenberg, Roland4, Moschovitis, Aris1, Lüscher, Thomas F.4, van Tits, Lambertus J.4, Matter, Christian M.4, Windecker, Stephan1, Räber, Lorenz1 lorenz.raeber@insel.ch |
| المصدر: |
Atherosclerosis (00219150). Apr2016, Vol. 247, p154-160. 7p. |
| مصطلحات موضوعية: |
*ATHEROSCLEROTIC plaque, *C-reactive protein, *STATINS (Cardiovascular agents), *MYOCARDIAL infarction treatment, *PATIENTS, *THERAPEUTICS |
| مستخلص: |
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. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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