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)

Cardiovascular complications are important causes of morbidity and mortality among BMT recipients. The preparative regimen for allogeneic BMT and long-term immunosuppression can induce atherosclerosis; in addition, the coronary endothelium is a potential target for the graft-versus-host immune response in chronic GVHD.

Background: The favorable effect of fish oils rich in n-3 polyunsaturated fatty acids

BACKGROUND While cardiac allograft vasculopathy (CAV) is typically characterized by diffuse coronary intimal thickening with pathological vessel remodeling, plaque instability may also play an important role in CAV. Previous studies of native coronary atherosclerosis have demonstrated associations between attenuated-signal plaque (ASP), plaque instability, and adverse clinical events. OBJECTIVES This study’s aim was to characterize the association between ASP and long-term mortality post-heart transplantation. METHODS In 105 heart transplant recipients, serial (baseline and 1-year post-transplant) intravascular ultrasound (IVUS) was performed in the first 50 mm of the left anterior descending artery. ASP score was calculated by grading the measured angle of attenuation from grades 0 to 4 (specifically, 0°, 1° to 90°, 91° to 180°, 181° to 270°, and >270°) at 1 mm intervals. The primary endpoint was all-cause death or retransplantation. RESULTS At 1-year post-transplant, 10.5% of patients demonstrated ASP progression (newly developed or increased ASP). Patients with ASP progression had a higher incidence of acute cellular rejection during the first year (63.6% vs. 22.3%; p = 0.006) and tendency for greater intimal growth (percent intimal volume: 9.2% ± 9.3% vs. 4.4% ± 5.3%; p = 0.07) than those without. Over a median follow-up of 4.6 years, there was a significantly lower event-free survival rate in patients with ASP progression at 1-year post-transplant compared to those without. In contrast, maximum intimal thickness did not predict long-term mortality. CONCLUSIONS ASP progression appears to reflect chronic inflammation related to acute cellular rejection and is an independent predictor of long-term mortality after heart transplantation. Serial assessments of plaque instability may enhance identification of high-risk patients who may benefit from closer follow-up and targeted medical therapies.