Original title: Changes in Plaque Lipid Content After Short-Term Intensive Versus Standard Statin Therapy. The YELLOW Trial (Reduction in Yellow Plaque by Aggressive Lipid-Lowering Therapy). Reference: Annapoorna S. Kini et al. J Am Coll Cardiol 2013;62:21–9.
Multiple studies have shown the benefits of statins in reducing all events, stabilize plaques and improve endothelial function. Coronary intravascular ultrasound (IVUS) reduction in nonsignificant atherosclerotic plaque volume has been objectivized after administration of statins, however severe plaque effect is unknown.
The aim of this study was to determine the impact of intensive lipid lowering over the lipid content and the physiology of severe plaques using spectroscopy (NIRS = near-infrared spectroscopy), fractional flow reserve (FFR) and IVUS. 87 patients were randomized to standard versus intensive lipid-lowering therapy (Rosuvastatin 40 mg) which were treated in a programmed culprit injury but also having other stenosis lesions with a diameter of> 70% and measuring FFR ≤ 0.8. None of the non-culprit injuries received angioplasty at the time of randomization. After 6 to 8 weeks these non-culprit injuries were evaluated again using angiography, FFR, IVUS and NIRS before any angioplasty. At the end of follow-up, cholesterol values
