Original title: Effect of high-intensity statin therapy on atherosclerosis in non-infarct-related coronary arteries (IBIS-4): a serial intravascular ultrasonography study. Reference: Räber L et al. Eur Heart J. 2015 Feb 21;36(8):490-500.

The long-term effect of intensive statin therapy on coronary atherosclerosis in patients admitted pursuing an ST segment elevation myocardial infarction is unknown. The aim of this study was to quantify the impact of high doses of statins in the volume and composition of plaques in the arteries unrelated to the infarction.Between 2009 and 2011, 103 patients admitted pursuing ST segment elevation myocardial infarction were performed a coronary intravascular ultrasound (IVUS) on the two arteries not responsibleof infarction after successful primary angioplasty to the guilty artery.

These patients were treated with 40 mg of rosuvastatin for 13 months and thereafter a serial analysis was performed with IVUS. The primary end point was the percentage change in plaque volume by IVUS.After 13 months a significant decrease in LDL and a significant increase in the value of HDL were observed. Reduced plaque volume in arteries unrelated to myocardial infarction 0.9% (IC 95% -1.56 to -0.25, p = 0.007).In 74% of the population regression of plates at least in one artery not infarct-relatedwas observed.The necrotic core showed no change (-0.05%; CI 95% -1.05 to 0.96%, p = 0.93) as well as the number of plates with thin fibrous cap (124 versus 116, p = 0.15).

Conclusion

After 13 months of high-dose rosuvastatin it was observed by IVUS a regression of plaques in the arteries unrelated to myocardial infarction.

Editorial comment

While the regression existed and was significant, this did not reach 1% of the volume of original plaque and this after more than a year of rosuvastatin 40 mg (dose that not all patients tolerate). The anatomical regression is significant but low impact on functional compromise that an injury can have.

SOLACI