Early Intervention With Rosuvastatin Decreases the Lipid Components of the Plaque in Acute Coronary Syndrome - Analysis Using Integrated Backscatter IVUS (ELAN Study)

Background: It has recently become possible to analyze coronary plaque characteristics by using integrated backscatter intravascular ultrasound (IB-IVUS). The aim of this study was to use this modality to evaluate the impact of early intervention with rosuvastatin on both the volume and tissue characteristics of non-culprit plaques in acute coronary syndrome (ACS). Methods and Results: Patients with ACS underwent IB-IVUS after percutaneous coronary intervention procedure and were administered rosuvastatin. Follow-up IB-IVUS was recorded 6 months later. We analyzed the changes in plaque burden and tissue characteristics in these patients. Plaque components were classified as calcified, fibrous, and lipid according IB-IVUS. We comprehensively analyzed 20 ACS patients. The low-density lipoprotein-cholesterol levels decreased significantly from 117 +/- 34 mg/dl to 73 +/- 19 mg/dl (P < 0.001) after statin therapy. Comparing the baseline images with the follow-up ones revealed a significant reduction in the plaque burden from 98.4 +/- 42.1 mm(3)/10 mm to 80.2 +/- 35.8 mm(3)/10 mm (P < 0.001) and in the lipid volume from 44.1 +/- 29.6 mm(3)/10 mm to 28.6 +/- 17.8 mm(3)/10 mm (P < 0.001). With respect to the % lipid volume, the reduction rate at follow-up showed a significant correlation with its baseline value (r=-0.498, P=0.024). Conclusions: Early intervention with rosuvastatin in ACS patients enabled significant reduction of the non-culprit plaque during 6 months. This regression was mainly due to the decrease in the lipid component of the plaque. (Circ J 2011; 75: 633-641)