Impact of statins therapy on morphological changes in lipid-rich plaques stratified by 10-Year framingham risk score: A serial optical coherence tomography study

Abstract

The aim of the study was to investigate the impact of statins therapy on morphological changes of lipid-rich plaques by OCT (optical coherence tomography) in patients with known CHD (coronary heart disease), stratified by FRS. Ninetyseven lipid-rich plaques from sixty-nine patients who received statins therapy and underwent serial OCT images (baseline, 6-month and 12-month) were divided into 2 groups according to the FRS (framingham risk score): low risk group A (FRS < 10%, N = 35, n = 45), moderate to high risk group B (FRS ≥ 10%, N =3 4, n = 52). Fibrous cap thickness (FCT) was measured at its thinnest part 3 times. Baseline characteristics were not different between the 2 groups. FCT sustained increased from baseline to 6-month and 12-month follow up in both group A (59.8 ± 20.4μm, 118.3 ± 62.5μm, and 158.8 ± 83.4μm respectively, P < 0.001) and group B (62.2 ± 16.8μm, 125.1 ± 78.7μm, 163.8 ± 75.5μm respectively, P < 0.001). Lipid index was significantly decreased in both group A (1862.1 ± 1164.5, 1530.3 ± 1108.7, 1322.9 ± 1080.4, P < 0.001) and group B (1646.6± 958.5, 1535.1 ± 1049.1, 1258.6 ± 1045, P = 0.016). The incidence of TCFA was decreased statistically in both group A (P < 0.001) and group B (P < 0.001). The patients with known CHD can equivalently benefit from statins therapy by stabilizing the lipid-rich plaques. Patients with moderate to high FRS might benefit more within the first year from event time.