Yonsei Med J.  2015 Jan;56(1):45-52. 10.3349/ymj.2015.56.1.45.

Impact of Statin Treatment on Strut Coverage after Drug-Eluting Stent Implantation

• Suh Y
• Kim BK
• Shin DH
• Kim JS
• Ko YG
• Choi D
• Jang Y
• Hong MK

• KMID: 2352788
• DOI: http://doi.org/10.3349/ymj.2015.56.1.45

Abstract

PURPOSE
To evaluate the effect of statin treatment on strut coverage after drug-eluting stent (DES) implantation.
MATERIALS AND METHODS
In this study, 60 patients were randomly assigned to undergo sirolimus-eluting stent (SES) or biolimus-eluting stent (BES) implantation, after which patients were randomly treated with pitavastatin 2 mg or pravastatin 20 mg for 6 months. The degree of strut coverage was assessed by 6-month follow-up optical coherence tomography, which was performed in 52 DES-implanted patients.
RESULTS
The percentages of uncovered struts were 19.4+/-14.7% in pitavastatin-treated patients (n=25) and 19.1+/-15.2% in pravastatin-treated patients (n=27; p=0.927). A lower percentage of uncovered struts was significantly correlated with a lower follow-up low-density lipoprotein (LDL) cholesterol level (r=0.486; p=0.009) and a greater decline of the LDL cholesterol level (r=-0.456; p=0.015) in SES-implanted patients, but not in BES-implanted patients. In SES-implanted patients, the percentage of uncovered struts was significantly lower among those with LDL cholesterol levels of less than 70 mg/dL after 6 months of follow-up (p=0.025), but no significant difference in this variable according to the follow-up LDL cholesterol level was noted among BES-implanted patients (p=0.971).
CONCLUSION
Lower follow-up LDL cholesterol levels, especially those less than 70 mg/dL, might have a protective effect against delayed strut coverage after DES implantation. This vascular healing effect of lower LDL cholesterol levels could differ according to the DES type.

Keyword

Stent; optical coherence tomography; statin

MeSH Terms

Adult
Coronary Angiography
*Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
Lipoproteins, LDL/blood
Male
Middle Aged
Pravastatin/therapeutic use
*Prosthesis Implantation
Quinolines/therapeutic use
Tomography, Optical Coherence
Treatment Outcome
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipoproteins, LDL
Quinolines
Pravastatin

Figure

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  Fig. 1 A flowchart of the study is shown.

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  Fig. 2 The relationships of the percentage of uncovered struts with follow-up low-density lipoprotein (LDL) cholesterol levels are presented. Black and red dots represent biolimus-eluting stents and sirolimus-eluting stents, respectively.

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  Fig. 3 The relationships of the percentage of uncovered struts with the degree of low-density lipoprotein (LDL) cholesterol level reduction are presented. Black and red dots represent biolimus-eluting stents and sirolimus-eluting stents, respectively.

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