Document Detail


Statins improve human coronary atherosclerotic plaque morphology.
MedLine Citation:
PMID:  18612439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Statin treatment markedly reduces the incidence of acute coronary events in patients with coronary atherosclerosis. Although imaging studies have indirectly shown the beneficial effects of statins on plaque morphology, there has to our knowledge been no reported histologic comparison of the morphology of coronary plaque in statin-treated versus untreated patients who had substantial coronary artery atherosclerosis. We retrospectively studied arterial sections from the native hearts of patients who had experienced end-stage ischemic heart disease and subsequent cardiac transplantation. Of 44 qualified patients, 33 study patients had received pre-transplantation statin therapy, and 11 control patients had not. Pathologic examination of each explanted heart confirmed coronary artery disease and previous myocardial infarction in all patients. Diabetes mellitus was more prevalent in the study group. The groups were similar in levels of total and low-density lipoprotein cholesterol, and in the available number of arterial cross-sections per patient. All patients had plaques. High-grade lesions were found in 66.3% of cross-sections in the control group, and in 34.6% in the study group (P=0.011). Conversely, the degree of inflammation was markedly lower in the study group: low-grade fibrous plaques occurred in 45.7% of cross-sections in the study group, versus 11.3% in the control group (P=0.006). The study group had significantly fewer high-grade plaques and more fibrous plaques than did the control group at the time of transplantation. Our findings show that statin therapy substantially enhances plaque stabilization. We further suggest that reduction of plaque inflammation is an important aspect of this stabilization.
Authors:
Stephanie D Reilly; Silvio H Litovsky; Michael P Steinkampf; James B Caulfield
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  35     ISSN:  0730-2347     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2008  
Date Detail:
Created Date:  2008-07-09     Completed Date:  2008-11-18     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  99-103     Citation Subset:  IM    
Affiliation:
Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama 35294-4550, USA. sreilly@uab.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Coronary Artery Disease / complications,  pathology*,  surgery
Databases, Factual
Female
Heart Transplantation
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Male
Middle Aged
Myocardial Infarction / etiology,  pathology,  therapy
Retrospective Studies
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comments/Corrections

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