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Maximum steroids ‘may stabilise plaques’


Maximum steroid doses have shown potential to stabilise atherosclerotic plaques and save percutaneous coronary intervention (PCI) patients from needing further interventions in high-profile research.

The findings, which were presented at the American College of Cardiology 2012 Scientific Sessions, add to positive findings that indicated statins may instigate regression of coronary atheroma.

The Reduction in Yellow Plaque by Aggressive Lipid Lowering (YELLOW) trial enrolled patients with multivessel, haemodynamically significant coronary lesions who had a fractional flow reserve (FFR) less than 0.8 and were eligible to undergo staged PCI at Mount Sinai Medical Center, according to Heartwire.

The coronary status of the patients was assessed at baseline using grayscale intravenous ultrasound (IVUS) and near-infrared spectroscopy (NIRS). They were then randomly assigned to receive dual antiplatelet therapy in addition to pre-existing statin therapy or an aggressive statin regime of 40 mg/day rosuvastatin.

NIRS analysis revealed a significantly reduced lipid core burden in aggressively treated compared with the standard therapy patients.

Given that patients who have plaques with an FFR below 0.8 are often treated by PCI, researcher Dr Samin Sharma from Mount Sinai Hospital suggested to Heartwire that, if the target vessel is treated with aggressive statin therapy, the need for secondary stent procedures may be avoided.

American College of Cardiology Scientific Sessions

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