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Lipid-lowering therapy stabilizes the complexity of non-culprit plaques in human coronary artery: a quantitative assessment using OCT bright spot algorithm

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Abstract

To quantitatively evaluate the change of plaque complexity with cholesterol lowering therapy. A total of 44 non-culprit plaques from 30 patients who had serial image acquisition at baseline, 6-months, and 12-months by both optical coherence tomography (OCT) and intravascular ultrasound (IVUS) were included. Patients were treated with atorvastatin 60 mg (AT60, n = 16) or 20 mg (AT20, n = 14). We applied an OCT bright spot algorithm, which identifies a variety of plaque components including macrophages. The density of bright spot was measured within the superficial 250 µm of the vessel wall. Significant reduction of bright spot density was observed from baseline to 12-months [−0.49% (−0.95, −0.20), p < 0.001], particularly during the second 6 months [first 6 months: −0.01% (−0.57, 0.60), p = 0.939; second 6 months: −0.49% (−0.98, 0.14), p < 0.001]. Although there was no significant difference at 12 months in the reduction of bright spot density between plaques with acute coronary syndrome (ACS, n = 33) and those with stable angina (n = 11) [−0.49% (−0.93, −0.19) vs. −0.39% (−1.01, −0.21), p = 0.748], a significant reduction of bright spot density during the first 6 months was observed only in plaques with ACS. There was no significant difference in the change of bright spot density between the AT60 group (n = 22) and AT20 group (n = 22) [−0.61% (−0.93, −0.34) vs. −0.41% (−0.98, −0.19), p = 0.483]. Coronary plaque complexity evaluated by a quantitative OCT algorithm significantly decreased with 12 month atorvastatin therapy irrespective of the dose and initial clinical presentation.

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Acknowledgements

The authors thank all the investigators, all supporting staff, and all the institutions of MGH OCT Registry for their contributions. The authors also thank Austin McElroy for his contribution to the development of the bright spot algorithm.

Funding

This study is supported by Clayton Foundation in Houston, Texas, Veterans Administration Merit Grant I01 BX000397, and American Heart Association Grant 13POST17080074. Ik-Kyung Jang received a research grant and honorarium from St. Jude Medical. IK Jang’s research was supported by Mr. and Mrs. Michael and Kathryn Park and Mrs. and Mr. Gill and Allan Gray.

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Authors and Affiliations

  1. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, GRB 800, 55 Fruit street, Boston, MA, 02114, USA

    Yoshiyasu Minami, Lei Xing & Ik-Kyung Jang

  2. University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA

    Taylor Hoyt, Jennifer E. Phipps & Marc D. Feldman

  3. Department of Biomedical Engineering, University of Texas, 107 W Dean Keeton Street Stop, Austin, TX, 78712, USA

    Thomas E. Milner

  4. Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Boston, MA, 02114, USA

    Hang Lee

  5. Department of Cardiology, The 2nd Affiliated Hospital of Harbin University, 246 Xuefu Road, Nangang District, Harbin, 150086, China

    Bo Yu

  6. Veterans Administration Health Care System, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA

    Marc D. Feldman

  7. Division of Cardiology, Kyung Hee University, 23 Kyunghee-daero, Dongdaemun-gu, Seoul, 130-701, South Korea

    Ik-Kyung Jang

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  1. Yoshiyasu Minami
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Correspondence to Ik-Kyung Jang.

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Ethical statement

The protocol for the registry was approved by each institution’s ethics committee, and all patients provided written informed consent. This study was performed in accordance with the Declaration of Helsinki.

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Minami, Y., Hoyt, T., Phipps, J.E. et al. Lipid-lowering therapy stabilizes the complexity of non-culprit plaques in human coronary artery: a quantitative assessment using OCT bright spot algorithm. Int J Cardiovasc Imaging 33, 453–461 (2017). https://doi.org/10.1007/s10554-016-1037-3

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  • DOI: https://doi.org/10.1007/s10554-016-1037-3

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