Effect of atorvastatin therapy on borderline vulnerable lesions in patients with acute coronary syndrome

Archives of Medical Science, 07/12/2011

Atorvastatin therapy stabilized borderline vulnerable plaques and reversed atherosclerosis progression in patients with acute coronary syndrome (ACS). Reversal of this progression was accompanied by a decrease in the levels of plasma matrix metalloproteinase–9 (MMP–9) and hsCRP. Changes in MMP–9 and high–sensitive C–reactive protein (hsCRP) could predict vulnerable plaque stabilization.

Methods

  • Fifty patients with ACS whose culprit lesions were classified as “borderline lesions” were enrolled.
  • All patients were treated with atorvastatin (20 mg) for 12 months.
  • Intravascular ultrasound (IVUS) was performed and matrix metalloproteinase–9 (MMP–9), tissue inhibitor of metalloproteinase–1 (TIMP–1), and high–sensitive C–reactive protein (hsCRP) levels were measured at baseline and 12–month follow–up.

Results

  • At 12–month follow–up, the authors found: 1) IVUS revealed that minimal lumen cross–sectional area (CSA) increased but plaque/media (P&M) area and plaque burden decreased.
  • A total of 25 soft plaques (50%) were transformed into fibrous plaques.
  • ApoB, MMP–9 and hsCRP levels decreased, but TIMP–1 level increased.
  • Stepwise multivariate linear regression analysis showed that the independent predictors for changes in P&M area/year were the decrease in MMP–9 and hsCRP levels.

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