Clinical InvestigationAcute Ischemic Heart DiseaseStatin treatment for coronary artery plaque composition based on intravascular ultrasound radiofrequency data analysis
Section snippets
Study design and ethical considerations
The TRUTH (treatment with statin on atheroma regression evaluated by IVUS with VH) study was a prospective, open-labeled, randomized, multicenter trial performed in 11 Japanese centers. The effects of pitavastatin and pravastatin on coronary artery plaque composition were assessed by VH-IVUS with 8 months of invasive follow-up.
The primary end point was the difference of volume changes in each of the 4 main plaque components measured by VH-IVUS between the 2 treatment groups. The secondary end
Patient populations
The study flow chart is shown in Figure 1. A total of 164 patients were enrolled; 82 patients were randomized to the pitavastatin group, and 82, to the pravastatin group. Intravascular ultrasound images qualifying for evaluation both at pretreatment and at follow-up were obtained in 58 patients (71%) in the pitavastatin group and 61 patients (74%) in the pravastatin group.
There were no significant differences in baseline characteristics between the 2 groups (Table I). The mean follow-up
Discussion
The main finding of the study was that both pitavastatin and pravastatin altered coronary artery plaque composition as assessed by VH-IVUS with a reduction of FF plaque component and increase of the calcified plaque component. Plaque progression occurs primarily because of increases in FI or FF components.13 In contrast to statin-induced plaque regression, these drugs may impact early stages of lipid accumulation, particularly the FF component.14, 15 Thus, the FF component may be a reversible
Conclusions
Both pitavastatin and pravastatin altered coronary artery plaque composition by significantly decreasing the FF component and increasing the DC component, whereas the volume changes in both plaque components were not statistically significant.
Disclosures
Funding Source: This study was supported by a grant from the Japan Heart Foundation.
Conflict of interest: None.
Acknowledgements
The authors acknowledge the contributions of Mr Yasuyoshi Suzuki and Mr Yoshiaki Nakayama in the IVUS core-laboratory management.
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