Changes in coronary plaque color and morphology by lipid-lowering therapy with atorvastatin: serial evaluation by coronary angioscopy
Masamichi Takano, MD, PhD*,
Kyoichi Mizuno, MD, PhD, FACC*,*,
Shinya Yokoyama, MD*,
Koji Seimiya, MD*,
Fumiyuki Ishibashi, MD*,
Kentaro Okamatsu, MD* and
Ryota Uemura, MD, PhD*
* Department of Internal Medicine, Nippon Medical School, Chiba-Hokusoh Hospital, Imba, Chiba, Japan
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Figure 1 (A) White plaque (yellow score: 0). (B) Light yellow plaque (yellow score: 1). (C) Yellow plaque (yellow score: 2). (D) Dark yellow plaque (yellow score: 3). (E) Yellow and irregular plaque (disrupted score: 1). (F) Yellow plaque with a red thrombus (disrupted score: 1).
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Figure 2 Changes in mean yellow score and mean disrupted score from baseline to follow-up. The open circles represent the comparison group (n = 16); the open squares represent the atorvastatin group (n = 15). In the atorvastatin group, the mean yellow score and mean disrupted score decreased significantly from baseline to follow-up. In the comparison group, the mean yellow score increased significantly.
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Figure 3 Changes in angioscopic findings from baseline to follow-up. (A) A right coronary angiogram of a patient in the atorvastatin group. (B) Yellow plaque in a patient in the atorvastatin group at baseline. Yellow plaque (yellow score: 3) was observed in the mid-portion of the right coronary artery at baseline (arrow in A). The surface of this plaque was smooth, and a thrombus was not noted (disrupted score: 0). (C) White plaque in a patient in the atorvastatin group at follow-up. After treatment with atorvastatin, the yellow plaque changed into a completely white plaque. Both the yellow score and disrupted score were 0. (D) A right coronary angiogram of a patient in the comparison group. (E) Yellow plaque in a patient in the comparison group at baseline. Yellow plaque (yellow score: 1) was observed in the mid-portion of the right coronary artery at baseline (arrow in D). The surface of this plaque was smooth, and a thrombus was not noted (disrupted score: 0). (F) Yellow plaque in a patient in the comparison group at follow-up. After 12 months of follow-up without lipid-lowering medication, the yellow score had increased to 2, and the surface of this plaque had become irregular (disrupted score: 1).
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Figure 4 Relationship between the change in the mean yellow score and the change in LDL-C levels from baseline to follow-up. There was a good correlation between the change in the mean yellow score and the change in LDL-C levels from baseline to follow-up.
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