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Effect of Atorvastatin on Serial Changesin Coronary Physiology andPlaque Parameters

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Author(s)
Cheol Hyun LeeJongmin HwangIn-Cheol KimYun-Kyeong ChoHyoung-Seob ParkHyuck-Jun YoonHyungseop KimSeongwook HanSeung-Ho HurKwon-Bae KimJin Young KimJin-Wook ChungJoo Myung LeeJoon-Hyung DohEun-Seok ShinBon-Kwon KooChang-Wook Nam
Keimyung Author(s)
Lee, Cheol HyunHwang, Jong MinKim, In CheolPark, Hyoung SeobYoon, Hyuck JunKim, Hyung SeopHan, Seong WookHur, Seung HoKim, Kwon BaeKim, Jin YoungNam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Dept. of Radiology (영상의학)
Journal Title
JACC Asia
Issued Date
2022
Volume
2
Issue
6
Keyword
CAD, coronary artery diseaseCFR, coronary flow reserveFFR, fractional flow reserveIMR, index of microcirculatory resistanceIVUS, intravascular ultrasoundLDL-C, low-density lipoprotein cholesterolLLT, lipid-lowering therapyMLA, minimal lumen areaOR, odds ratioPAV, percent atheroma volumePa, proximal aortic pressurePd, distal coronary pressureTAV, total atheroma volumeTmn, mean transit timeVH, virtual histologyfractional flow reserveintermediate coronary artery diseasestatin therapy
Abstract
Background:
The effects of statin on coronary physiology have not been well evaluated.

Objectives:
The authors performed this prospective study to investigate changes in coronary flow indexes and plaque parameters, and their associations with atorvastatin therapy in patients with coronary artery disease (CAD).

Methods:
Ninety-five patients with intermediate CAD who received atorvastatin therapy underwent comprehensive physiological assessments with fractional flow reserve (FFR), coronary flow reserve, index of microcirculatory resistance, and intravascular ultrasound at the index procedure, and underwent the same evaluations at 12-month follow-up. Optimal low-density lipoprotein cholesterol (LDL-C) was defined as LDL-C <70 mg/dL or ≥50% reduction from the baseline. The primary endpoint was a change in the FFR.

Results:
Baseline FFR, minimal lumen area, and percent atheroma volume (PAV) were 0.88 ± 0.05, 3.87 ± 1.28, 55.92 ± 7.30, respectively. During 12 months, the percent change in LDL-C was -33.2%, whereas FFR was unchanged (0.87 ± 0.06 at 12 months; P = 0.694). Vessel area, lumen area, and PAV were significantly decreased (all P values <0.05). The achieved LDL-C level and the change of PAV showed significant inverse correlations with the change in FFR. In patients with optimally modified LDL-C, the FFR had increased (0.87 ± 0.06 vs 0.89 ± 0.07; P = 0.014) and the PAV decreased (56.81 ± 6.44% vs 55.18 ± 8.19%; P = 0.031), whereas in all other patients, the FFR had decreased (0.88 ± 0.05 vs 0.86 ± 0.06; P = 0.025) and the PAV remained unchanged.

Conclusions:
In patients with CAD, atorvastatin did not change FFR despite a decrease in the PAV. However, in patients who achieved the optimal LDL-C target level with atorvastatin, the FFR had significantly increased with decrease of the PAV. (Effect of Atorvastatin on Fractional Flow Reserve in Coronary Artery Disease [FORTE]; NCT01946815).
Keimyung Author(s)(Kor)
이철현
황종민
김인철
박형섭
윤혁준
김형섭
한성욱
허승호
김권배
김진영
남창욱
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2772-3747
Source
https://www.sciencedirect.com/science/article/pii/S2772374722002149?via%3Dihub
DOI
10.1016/j.jacasi.2022.07.010
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44768
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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