Background: We used serial intravascular ultrasound (IVUS) to compare the effects of moderate doses of rosuvastatin and atorvastatin on plaque regression in patients with intermediate coronary stenosis.
Methods: This study was a prospective, randomized, and comparative study for lipid lowering therapy with rosuvastatin 20 mg (n=65) and atorvastatin 40 mg (n=63) using serial IVUS examinations (baseline and 11-month follow-up). Efficacy parameters included changes in total atheroma volume (TAV) and percent atheroma volume (PAV) from baseline to follow-up.
Results: Changes of TAV (-4.4±7.3 vs. -3.6±6.8 mm3, p=0.5) and PAV (-0.73±2.05 vs. -0.19±2.00 %, p=0.14) from baseline to follow-up were not different significantly between two groups. Plaque was progressed in 15% in rosuvastatin group and in 30% in atorvastatin group at follow-up (p=0.064). Plaque progressors had higher baseline high-sensitivity C-reactive protein (hs-CRP) (1.28±2.70 vs. 0.54±1.16 mg/dl, p=0.034) and higher follow-up low-density lipoprotein cholesterol (LDL-C) (78±24 vs. 63±21 mg/dl, p=0.002) compared with plaque regressors. Follow-up LDL-C (OR 1.038, 95% CI 1.003-1.060, p=0.036) and baseline hs-CRP (OR 1.025, 95% CI 1.001-1.059, p=0.046), not the type of statin, were the independent predictors of plaque progression at follow-up.
Conclusion: Moderate doses of rosuvastatin and atorvastatin could contribute to the effective plaque regression. Follow-up LDL-C and baseline hs-CRP are associated with plaque progression in patients with intermediate coronary stenosis.
Key Words: Coronary Disease; Plaque; Lipid; Intravascular Ultrasound
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