2.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.
Young Joon HONG ; Myung Ho JEONG ; Yun Ha CHOI ; Eun Hye MA ; Jum Suk KO ; Min Goo LEE ; Keun Ho PARK ; Doo Sun SIM ; Nam Sik YOON ; Hyun Ju YOUN ; Kye Hun KIM ; Hyung Wook PARK ; Ju Han KIM ; Youngkeun AHN ; Jeong Gwan CHO ; Jong Chun PARK ; Jung Chaee KANG
The Korean Journal of Internal Medicine 2010;25(4):356-363
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.
Adult
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Aged
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*Angioplasty, Balloon, Coronary
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Coronary Angiography
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Coronary Artery Disease/*drug therapy/ultrasonography
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Coronary Vessels/*drug effects/pathology/ultrasonography
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Female
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
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Lipids/blood
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Male
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Metals
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Middle Aged
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Retrospective Studies
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Simvastatin/*therapeutic use
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*Stents
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*Ultrasonography, Interventional