Korean J Intern Med.  2010 Dec;25(4):356-363. 10.3904/kjim.2010.25.4.356.

Usual Dose of Simvastatin Does Not Inhibit Plaque Progression and Lumen Loss at the Peri-Stent Reference Segments after Bare-Metal Stent Implantation: A Serial Intravascular Ultrasound Analysis

• Hong YJ
• Jeong MH
• Choi YH
• Ma EH
• Ko JS
• Lee MG
• Park KH
• Sim DS
• Yoon NS
• Youn HJ
• Kim KH
• Park HW
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 964715
• DOI: http://doi.org/10.3904/kjim.2010.25.4.356

Abstract

BACKGROUND/AIMS
The aim of this study was to assess the effects of a usual dose of simvastatin (20 mg/day) on plaque regression and vascular remodeling at the peri-stent reference segments after bare-metal stent implantation.
METHODS
We retrospectively investigated serial intravascular ultrasound (IVUS) findings in 380 peri-stent reference segments (184 proximal and 196 distal to the stent) in 196 patients (simvastatin group, n = 132 vs. non-statin group, n = 64). Quantitative volumetric IVUS analysis was performed in 5-mm vessel segments proximal and distal to the stent.
RESULTS
IVUS follow-up was performed at a mean of 9.4 months after stenting (range, 5 to 19 months). No significant differences were observed in the changes in mean plaque plus media (P&M) area, mean lumen area, and mean external elastic membrane (EEM) area from post-stenting to follow-up at both proximal and distal edges between the simvastatin and non-statin group. Although lumen loss within the first 3 mm from each stent edge was primarily due to an increase in P&M area rather than a change in EEM area, and lumen loss beyond 3 mm from each stent edge was due to a combination of increased P&M area and decreased EEM area, no significant differences in changes were observed in P&M, EEM, and lumen area at every 1-mm subsegment between the simvastatin and non-statin group.
CONCLUSIONS
A usual dose of simvastatin does not inhibit plaque progression and lumen loss and does not affect vascular remodeling in peri-stent reference segments in patients undergoing bare-metal stent implantation.

Keyword

Atherosclerosis; Ultrasonography, interventional; Lipids; Plaque

MeSH Terms

Adult
Aged
*Angioplasty, Balloon, Coronary
Coronary Angiography
Coronary Artery Disease/*drug therapy/ultrasonography
Coronary Vessels/*drug effects/pathology/ultrasonography
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
Lipids/blood
Male
Metals
Middle Aged
Retrospective Studies
Simvastatin/*therapeutic use
*Stents
*Ultrasonography, Interventional