Changes in coronary plaque color and morphology by lipid-lowering therapy with atorvastatin: serial evaluation by coronary angioscopy

Takano, Masamichi; Mizuno, Kyoichi; Yokoyama, Shinya; Seimiya, Koji; Ishibashi, Fumiyuki; Okamatsu, Kentaro; Uemura, Ryota

doi:10.1016/s0735-1097(03)00770-8

Cited by 134 publications

(96 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Continuous strong-statin therapy for 12 months leads to a masked reduction of LDL-C levels and a yellow color of coronary plaques at non-culprit lesions 18) . In other words, aggressive LDL-C lowering (around 100 mg/dL) changed the average plaque color to light yellow, not intense yellow in this study.…”

Section: Discussionmentioning

confidence: 99%

Intense Yellow Culprit Plaque Coloration is Closely Associated with Troponin-T Elevation and Flow Complications Following Elective Coronary Stenting

Murakami

Takano

Yamamoto

et al. 2011

JAT

Self Cite

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Intense Yellow Culprit Plaque Coloration is Closely Associated with Troponin-T Elevation and Flow Complications Following Elective Coronary Stenting

Murakami

Takano

Yamamoto

et al. 2011

JAT

Self Cite

View full text Add to dashboard Cite

“…Thus, the power of serum levels of CRP in predicting disease activity should also be confirmed. Furthermore, the same authors have previously reported that statin therapy reduces the serum CRP level and angioscopic complexity of the plaques (the existence of the thrombus and the irregularity of the plaque) in nonculprit lesions (Takano et al, 2003). In this study, data from univariate logistic regression analyses indicated that both statin therapy and serum CRP level at follow-up are considered predictors of healing in nonculprit ruptured plaques.…”

Section: Soluble Biomarkersmentioning

confidence: 50%

Biomarkers and Coronary Atherosclerotic Burden and Activity as Assessed by Coronary Angiography and Intra-Coronary Imaging Modalities

Loria¹,

Cosentino²,

Montone³

et al. 2011

Coronary Angiography - Advances in Noninvasive Imaging Approach for Evaluation of Coronary Artery Disease

View full text Add to dashboard Cite

“…26) These should make thin fibrous caps thicker and appear to reduce angioscopic yellow grade. 27) Recently, aspiration thrombectomies have been reported to be associated with decreased thrombi and clinical events. 28) Therefore, aggressive lipid-lowering therapy and volume reduction of the thrombus with thrombolysis or a thrombectomy before stenting may promote NSC over an intense yellow plaque with a thrombus.…”

Section: Discussionmentioning

confidence: 99%

Difference in Neointimal Proliferation Between Ruptured and Non-Ruptured Segments After Bare Metal Stent Implantation

et al. 2010

Self Cite

View full text Add to dashboard Cite

SummaryThe difference in neointimal stent coverage (NSC) between ruptured segments and adjacent nonruptured segments in infarct-related lesions (IRL) of acute myocardial infarction after bare metal stent (BMS) implantation was evaluated using coronary angioscopy. Serial angioscopic observations were performed for 19 IRLs immediately after the implantation of a BMS and at 1-month and 6-month follow-up. Stented segments were divided into the ruptured segment and the nonruptured segment based on the presence of a thrombus. The grade of NSC was divided into 0 = complete exposure, 1 = partial coverage, or 2 = complete coverage. The grade of plaque color was classified semiquantitatively as 0 = white, 1 = light yellow, or 2 = intense yellow. The existence of a thrombus was also determined. The grade of NSC in the ruptured segment was lower than that of the nonruptured segment at each follow-up. The grade of plaque color at the 1-month follow-up was higher in the ruptured segment than in the nonruptured segment. At 6 months, the grade of plaque color was similar between the ruptured and nonruptured segments. In all cases, thrombi existed in the ruptured segments immediately after stenting. Although thrombi still remained frequently at 1-month, most had disappeared at the 6-month follow-up. Neointimal proliferation of the ruptured segment in IRL advanced slowly in comparison to the adjacent nonruptured segment. The presence of an atherosclerotic yellow plaque and a thrombus may affect the delayed neointimal coverage after BMS implantation. (Int Heart J 2010; 51: 7-12) Key words: Acute myocardial infarction, Stent, Neointima, Plaque R ecently, a late thrombosis after stent implantation has emerged as a major clinical concern regardless of the type of stent, such as a bare metal stent (BMS) or a drug-eluting stent, because it is a life-threatening complication.1-3) The principal mechanisms of the late stent thrombosis are delayed endothelialization, lack of neointimal stent coverage (NSC), and the presence of persistent uncovered stent struts. 4,5) Several follow-up studies after stent implantation using coronary angioscopy demonstrated that NSC had an effect on plaque stabilization due to the complete sealing of the stent by the neointima underlying the ruptured plaque regardless of any unstable clinical settings, such as an acute myocardial infarction (AMI). 6,7)Moreover, NSC after stent implantation has a different time course between patients with an AMI and those with stable angina pectoris. 7,8) The major causes of an AMI are understood to be the disruption of atherosclerotic vulnerable plaques and subsequent thrombus formation and a vulnerable plaque is recognized as yellow by coronary angioscopy.9-11) Although a coronary stent is deployed on the ruptured segment, the location of the stent extends to the nonruptured segment beyond the ruptured segment. Angioscopic plaque morphology between the ruptured and nonruptured segments is quite different. The ruptured segment is defined as the site of a vulnerable yellow pl...

show abstract

Changes in coronary plaque color and morphology by lipid-lowering therapy with atorvastatin: serial evaluation by coronary angioscopy

Abstract: This is the first report clarifying detailed changes in coronary plaque by statin in humans. This study indicated that lipid-lowering therapy changes plaque color and morphology and should then lead to coronary plaque stabilization.

Cited by 134 publications

References 24 publications

Intense Yellow Culprit Plaque Coloration is Closely Associated with Troponin-T Elevation and Flow Complications Following Elective Coronary Stenting

Intense Yellow Culprit Plaque Coloration is Closely Associated with Troponin-T Elevation and Flow Complications Following Elective Coronary Stenting

Biomarkers and Coronary Atherosclerotic Burden and Activity as Assessed by Coronary Angiography and Intra-Coronary Imaging Modalities

Difference in Neointimal Proliferation Between Ruptured and Non-Ruptured Segments After Bare Metal Stent Implantation

Contact Info

Product

Resources

About