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dc.contributor.authorGu, Sophie
dc.contributor.authorCostopoulos, Charis
dc.contributor.authorHuang, Yuan
dc.contributor.authorBourantas, Christos
dc.contributor.authorWoolf, Adam
dc.contributor.authorSun, Chang
dc.contributor.authorTeng, Zhongzhao
dc.contributor.authorLosdat, Sylvain
dc.contributor.authorRäber, Lorenz
dc.contributor.authorSamady, Habib
dc.contributor.authorBennett, Martin
dc.date.accessioned2021-11-16T00:30:47Z
dc.date.available2021-11-16T00:30:47Z
dc.date.issued2021-11
dc.identifier.issn2752-4191
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330662
dc.description.abstractAims: Plaque structural stress (PSS) is a major cause of atherosclerotic plaque rupture and major adverse cardiovascular events (MACE). We examined the predictors of changes in peak and mean PSS (ΔPSSpeak, ΔPSSmean) in three studies of patients receiving either standard medical or high-intensity statin (HIS) treatment. Methods and results: We examined changes in PSS, plaque size, and composition between 7348 co-registered baseline and follow-up virtual-histology intravascular ultrasound images in patients receiving standard medical treatment (controls, n = 18) or HIS (atorvastatin 80 mg, n = 20, or rosuvastatin 40 mg, n = 22). The relationship between changes in PSSpeak and plaque burden (PB) differed significantly between HIS and control groups (P < 0.001). Notably, PSSpeak increased significantly in control lesions with PB >60% (P = 0.04), but not with HIS treatment. However, ΔPSSpeak correlated poorly with changes in lumen and plaque area or PB, plaque composition, or lipid lowering. In contrast, ΔPSSpeak correlated significantly with changes in lumen curvature, irregularity, and roughness (P < 0.05), all of which were reduced in HIS patients. ΔPSSmean correlated with changes in lumen area, PA, PB, and circumferential calcification, and was unchanged with either treatment. Conclusion: Our observational study shows that PSSpeak changes over time were associated with baseline disease severity and treatment. The PSSpeak increase seen in advanced lesions with standard treatment was associated with remodelling artery geometry and plaque architecture, but this was not seen after HIS treatment. Smoothing plaques by reducing plaque/lumen roughness, irregularity, and curvature represents a novel mechanism whereby HIS may reduce PSS and, thus may protect against plaque rupture and MACE.
dc.publisherOxford University Press (OUP)
dc.rightsAll rights reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.titleHigh-intensity statin treatment is associated with reduced plaque structural stress and remodelling of artery geometry and plaque architecture.
dc.typeArticle
prism.publicationNameEur Heart J Open
dc.identifier.doi10.17863/CAM.78107
dcterms.dateAccepted2021-11-12
rioxxterms.versionofrecord10.1093/ehjopen/oeab039
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2021-11-11
dc.contributor.orcidGu, Sophie [0000-0001-7698-0373]
dc.contributor.orcidBennett, Martin [0000-0002-2565-1825]
dc.identifier.eissn2752-4191
rioxxterms.typeJournal Article/Review
pubs.funder-project-idDepartment of Health (via National Institute for Health Research (NIHR)) (202375)
pubs.funder-project-idBritish Heart Foundation (PG/16/24/32090)
pubs.funder-project-idBritish Heart Foundation (FS/19/66/34658)
cam.issuedOnline2021-11-17
cam.orpheus.successWed Mar 23 10:26:16 GMT 2022 - Embargo updated
cam.orpheus.counter3
rioxxterms.freetoread.startdate2021-11-17


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