Abstract
Background
Low-density lipoprotein cholesterol (LDL-C) lowering is one of the cornerstones for plaque stabilization. Near-infrared spectroscopy (NIRS) allows to assess lipid content in atherosclerotic lesions. Aim of this study was to compare the effect of high-dose atorvastatin and rosuvastatin as a part of intensive lipid-lowering therapy for LDL-C and plaque lipid content reduction.
Methods
Stable coronary artery disease patients with premature atherosclerosis and 20-50% atherosclerotic plaque in coronary angiography were enrolled. Patients received high-intensity statin (atorvastatin 40 and 80 mg or rosuvastatin 20 and 40 mg) and ezetimibe if indicated. In case LDL-C was >1.8 mmol/l (70 mg/dl) after a run-in period of 4-6 weeks, therapy was escalated with add-on inclisiran. Baseline LDL-C refers to the value at the time of optimal lipid-lowering therapy initiation. NIRS-derived maximum lipid-core burden index within 4 mm (maxLCBI4 mm) of the segment of interest was established at baseline and after 15 months. For data analysis SPSS Statistics software was used with significance level of 0.05.
Results
Data regarding 39 patients was analyzed, of which 12 received atorvastatin and 27 - rosuvastatin. Inclisiran was administered to 33.3% of patients in atorvastatin group and 63.0% in rosuvastatin group (P=0.087). Ezetimibe proportion was greater in rosuvastatin group than among atorvastatin users - 85.2% and 25.0%, respectively (P<0.001). Baseline LDL-C in atorvastatin group was 3.01 mmol/l and 2.48 mmol/l in rosuvastatin group (P=0.046). During 15 months LDL-C was reduced by 36.5% (P=0.028) with atorvastatin and by 28.6% (P=0.002) with rosuvastatin. At 15-month follow-up LDL-C was 1.75 mmol/l and 1.76 mmol/l in both groups, respectively (P=1.000). Baseline maxLCBI4 mm was 196.75 and 219.44 among atorvastatin and rosuvastatin users, respectively (P=0.799). We observed maxLCBI4mm decrease in atorvastatin group by 65.2% and 36.4% in rosuvastatin group (P=0.045).
Conclusion
Intensive lipid-lowering therapy effectively reduces LDL-C along with LCBI decrease. In this study high-dose atorvastatincontaining regimen demonstrated greater effect on plaque lipid content.
Low-density lipoprotein cholesterol (LDL-C) lowering is one of the cornerstones for plaque stabilization. Near-infrared spectroscopy (NIRS) allows to assess lipid content in atherosclerotic lesions. Aim of this study was to compare the effect of high-dose atorvastatin and rosuvastatin as a part of intensive lipid-lowering therapy for LDL-C and plaque lipid content reduction.
Methods
Stable coronary artery disease patients with premature atherosclerosis and 20-50% atherosclerotic plaque in coronary angiography were enrolled. Patients received high-intensity statin (atorvastatin 40 and 80 mg or rosuvastatin 20 and 40 mg) and ezetimibe if indicated. In case LDL-C was >1.8 mmol/l (70 mg/dl) after a run-in period of 4-6 weeks, therapy was escalated with add-on inclisiran. Baseline LDL-C refers to the value at the time of optimal lipid-lowering therapy initiation. NIRS-derived maximum lipid-core burden index within 4 mm (maxLCBI4 mm) of the segment of interest was established at baseline and after 15 months. For data analysis SPSS Statistics software was used with significance level of 0.05.
Results
Data regarding 39 patients was analyzed, of which 12 received atorvastatin and 27 - rosuvastatin. Inclisiran was administered to 33.3% of patients in atorvastatin group and 63.0% in rosuvastatin group (P=0.087). Ezetimibe proportion was greater in rosuvastatin group than among atorvastatin users - 85.2% and 25.0%, respectively (P<0.001). Baseline LDL-C in atorvastatin group was 3.01 mmol/l and 2.48 mmol/l in rosuvastatin group (P=0.046). During 15 months LDL-C was reduced by 36.5% (P=0.028) with atorvastatin and by 28.6% (P=0.002) with rosuvastatin. At 15-month follow-up LDL-C was 1.75 mmol/l and 1.76 mmol/l in both groups, respectively (P=1.000). Baseline maxLCBI4 mm was 196.75 and 219.44 among atorvastatin and rosuvastatin users, respectively (P=0.799). We observed maxLCBI4mm decrease in atorvastatin group by 65.2% and 36.4% in rosuvastatin group (P=0.045).
Conclusion
Intensive lipid-lowering therapy effectively reduces LDL-C along with LCBI decrease. In this study high-dose atorvastatincontaining regimen demonstrated greater effect on plaque lipid content.
Original language | English |
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Pages (from-to) | 1278 |
Journal | Journal of the American College of Cardiology |
Volume | 83 |
Issue number | 13, Suppl. |
DOIs | |
Publication status | Published - 2 Apr 2024 |
Externally published | Yes |
Event | 73rd Annual Scientific Session & Expo of the American-College-of-Cardiology - Atlanta, United States Duration: 6 Apr 2024 → 8 Apr 2024 Conference number: 72 https://www.expo.acc.org/ACC24/Public/enter.aspx |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.3. Publications in conference proceedings indexed in Web of Science and/or Scopus database