Effect of pitavastatin treatment on changes of plaque volume and composition according to the reduction of high-sensitivity C-reactive protein levels.

BACKGROUND

There are few data regarding the effect of statins on regression and compositional changes of plaque according to the reduction in high-sensitivity C-reactive protein (hs-CRP) levels in acute myocardial infarction (AMI) patients.

METHODS

We used serial virtual histology-intravascular ultrasound to assess the efficacy of pitavastatin (dosage: 2mg/day) on plaque regression and compositional changes according to the degree of reduction in hs-CRP levels from baseline to follow-up [≥1mg/dl (n=62) vs. <1mg/dl (n=32)] in non-intervened non-infarct related artery in AMI patients who were enrolled in the Livalo in acute myocardial infarction study (LAMIS).

RESULTS

Total atheroma and percent atheroma volumes decreased more significantly in patients with reduction in hs-CRP ≥1mg/dl compared with those with reduction in hs-CRP <1mg/dl (-1.7±12.4mm(3) vs. +2.7±7.8mm(3), p<0.015, and -0.4±3.4% vs. +0.4±4.8%, p<0.001, respectively). Absolute and %necrotic core volumes decreased more significantly in patients with reduction in hs-CRP ≥1mg/dl compared with those with reduction in hs-CRP <1mg/dl (-0.4±3.5mm(3) vs. +1.9±3.4mm(3), p=0.038, and -1.1±4.9% vs. +2.7±4.7%, p=0.016, respectively). Reduction in hs-CRP ≥1mg/dl at follow-up was the independent predictor of reduction of percent atheroma volume and %necrotic core volume at follow-up [odds ratio (OR), 2.228; 95% confidence interval (CI), 1.390-2.977, p=0.016, and OR, 2.204; 95% CI, 1.512-2.916, p=0.020, respectively].

CONCLUSIONS

Reduction in hs-CRP levels in AMI patients plays an important role in the beneficial effects of statins on the regression and compositional change of coronary plaque.