AIMS: Chronic pre-treatment with statins may reduce mortality and morbidity in patients experiencing acute coronary syndromes (ACS), but mechanisms accounting for these findings are not completely understood. METHODS AND RESULTS: The optical coherence tomography (OCT)-Formidable registry retrospectively enrolled 285 consecutive patients with ACS undergoing OCT in 9 European centres. Mean age was 60.4 ± 12.8 years, 148 (51.9%) patients had hyperlipemia, 45 (15.8%) diabetes mellitus and 142 (49.8%) presented with ST Segment Elevation Myocardial Infarction (STEMI). Patients were stratified according to statin prescription: 150 (52.6%) were on chronic pre-treatment with statins before ACS and were more likely to present with non-ST segment elevation acute coronary syndromes (NSTE-ACS) at admission (111, 74%) rather than STEMI, while the opposite was observed for patients not on statins. The primary end-point of ruptured plaque at OCT occurred significantly less frequently in the patients on chronic pre-treatment with statins [odds ratio (OR) 0.375, 95% confidence interval (CI) 0.185-0.759, P = 0.006]. The secondary end-point of thin-cap fibro-atheroma (TCFA) at any site was significantly less frequent in the statin group (OR 0.423, 95%CI 0.213-0.840, P = 0.014). No differences were observed for the secondary end-point of not-ruptured TCFA as the culprit lesion. Pre-specified sensitivity analysis was conducted according to the pattern of ACS: the reported differences were confirmed for NSTE-ACS patients, with a trend towards less plaque rupture and a significant reduction of TCFA at any site with statins, but not for STEMI. CONCLUSIONS: Chronic pre-treatment with statins is associated with a reduced prevalence of ruptured plaques in patients presenting with ACS, particularly in those with NSTE-ACS. Statins bear hence the potential to reduce morbidity during the acute phase of ACS.

Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes. insights from the optical coherence tomography (OCT)-FORMIDABLE registry / Gili, Sebastiano; Iannaccone, Mario; Colombo, Francesco; Montefusco, Antonio; Amabile, Nicolas; Calcagno, Simone; Capodanno, Davide; Scalone, Giancarla; Rognoni, Andrea; Omedè, Pierluigi; Ugo, Fabrizio; Cavallo, Erika; Mancone, Massimo; Mangiameli, Andrea; Boccuzzi, Giacomo; Hiansen, Joshua; Motreff, Pascal; Toutouzas, Konstantinos; Garbo, Roberto; Sardella, Gennaro; Tamburino, Corrado; D'Amico, Maurizio; Moretti, Claudio; Templin, Christian; Gaita, Fiorenzo; Souteyrand, Geraud; Niccoli, Giampaolo; D'Ascenzo, Fabrizio. - In: EUROPEAN HEART JOURNAL. CARDIOVASCULAR IMAGING. - ISSN 2047-2404. - ELETTRONICO. - 19:5(2018), pp. 524-531. [10.1093/ehjci/jex102]

Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes. insights from the optical coherence tomography (OCT)-FORMIDABLE registry

CALCAGNO, SIMONE;MANCONE, Massimo;SARDELLA, Gennaro;
2018

Abstract

AIMS: Chronic pre-treatment with statins may reduce mortality and morbidity in patients experiencing acute coronary syndromes (ACS), but mechanisms accounting for these findings are not completely understood. METHODS AND RESULTS: The optical coherence tomography (OCT)-Formidable registry retrospectively enrolled 285 consecutive patients with ACS undergoing OCT in 9 European centres. Mean age was 60.4 ± 12.8 years, 148 (51.9%) patients had hyperlipemia, 45 (15.8%) diabetes mellitus and 142 (49.8%) presented with ST Segment Elevation Myocardial Infarction (STEMI). Patients were stratified according to statin prescription: 150 (52.6%) were on chronic pre-treatment with statins before ACS and were more likely to present with non-ST segment elevation acute coronary syndromes (NSTE-ACS) at admission (111, 74%) rather than STEMI, while the opposite was observed for patients not on statins. The primary end-point of ruptured plaque at OCT occurred significantly less frequently in the patients on chronic pre-treatment with statins [odds ratio (OR) 0.375, 95% confidence interval (CI) 0.185-0.759, P = 0.006]. The secondary end-point of thin-cap fibro-atheroma (TCFA) at any site was significantly less frequent in the statin group (OR 0.423, 95%CI 0.213-0.840, P = 0.014). No differences were observed for the secondary end-point of not-ruptured TCFA as the culprit lesion. Pre-specified sensitivity analysis was conducted according to the pattern of ACS: the reported differences were confirmed for NSTE-ACS patients, with a trend towards less plaque rupture and a significant reduction of TCFA at any site with statins, but not for STEMI. CONCLUSIONS: Chronic pre-treatment with statins is associated with a reduced prevalence of ruptured plaques in patients presenting with ACS, particularly in those with NSTE-ACS. Statins bear hence the potential to reduce morbidity during the acute phase of ACS.
2018
acute coronary syndromes; optical coherence tomography; statin therapy
01 Pubblicazione su rivista::01a Articolo in rivista
Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes. insights from the optical coherence tomography (OCT)-FORMIDABLE registry / Gili, Sebastiano; Iannaccone, Mario; Colombo, Francesco; Montefusco, Antonio; Amabile, Nicolas; Calcagno, Simone; Capodanno, Davide; Scalone, Giancarla; Rognoni, Andrea; Omedè, Pierluigi; Ugo, Fabrizio; Cavallo, Erika; Mancone, Massimo; Mangiameli, Andrea; Boccuzzi, Giacomo; Hiansen, Joshua; Motreff, Pascal; Toutouzas, Konstantinos; Garbo, Roberto; Sardella, Gennaro; Tamburino, Corrado; D'Amico, Maurizio; Moretti, Claudio; Templin, Christian; Gaita, Fiorenzo; Souteyrand, Geraud; Niccoli, Giampaolo; D'Ascenzo, Fabrizio. - In: EUROPEAN HEART JOURNAL. CARDIOVASCULAR IMAGING. - ISSN 2047-2404. - ELETTRONICO. - 19:5(2018), pp. 524-531. [10.1093/ehjci/jex102]
File allegati a questo prodotto
File Dimensione Formato  
Gili_Effects_2018.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 267.91 kB
Formato Adobe PDF
267.91 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1007726
Citazioni
  • ???jsp.display-item.citation.pmc??? 9
  • Scopus 29
  • ???jsp.display-item.citation.isi??? 28
social impact