YELLOW II: Evaluation of Plaque Morphology Following Intensive Statin Therapy

Intensive statin therapy may lead to plaque stabilization, according to the results of the YELLOW II Trial presented at TCT 2016 and simultaneously published in the Journal of the American College of Cardiology.

Annapoorna S. Kini, MBBS, FACC, et al., assessed the changes in cholesterol efflux capacity (CEC) following intravascular imaging in 85 patients with stable multivessel coronary artery disease who underwent percutaneous coronary intervention (PCI) for culprit lesion. PCI was followed by optical coherence tomography (OCT) of an obstructive non-culprit lesion. All patients received 40mg of rosuvastatin every day for eight – 12 weeks, at which point OCT was performed again on the obstructive non-culprit lesion and intervention occurred.

The results of the study showed an independent association between the thickening of the fibrous cap and improved CEC, which the authors note may suggest plaque stabilization among patients on intensive statin therapy. At follow-up OTC, median fibrous cap thickness and CEC increased to 108.6 μm and 0.84, from 100.9 μm and 0.81 at baseline, respectively. Further, the prevalence of thin-cap fibroatheroma reduced from 20.0 percent to 7.1 percent.

The authors note that “the significant transcriptomic perturbations related to cholesterol synthesis, regulation of fatty acid unsaturation, cellular cholesterol uptake, efflux and inflammation may co-operate in determining the beneficial effects of statin on plaque stabilization.”

Clinical Topics: Dyslipidemia, Invasive Cardiovascular Angiography and Intervention, Stable Ischemic Heart Disease, Nonstatins, Novel Agents, Statins, Interventions and Imaging, Angiography, Nuclear Imaging, Chronic Angina

Keywords: Transcatheter Cardiovascular Therapeutics, Angina, Stable, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Inflammation, Plaque, Atherosclerotic, Rhodamines, Transcriptome, Angiography

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