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vendredi 28 août 2015

Intensive statin therapy in AMI patients: disappointing results at 12 months



The results after 12 months in this RCT which was blinded only for radiologists who made the plaque evaluation are rather disappointing or at best mitigated.
Comparatively to the standard regime the intensive statin therapy showed:
-no depletion in the fatty content of the plaque, indeed the two regimes led to an increase in the total plaque volume.
-an increase of the calcium content of the plaque in the intensive group
-no decrease in the MACE
-a decrease the "vulnerability" of the predetermined vulnerable plaques as assessed by total volumes but only for the patients treated with an intensive regime. The vulnerable patients were 18/96/140 and 18 plaques , 8 in the conventional regime and 10 in the intensive one.

Table 1
Size of the cohort                        140 patients recruted             96 evaluable patients

Treatment                                    Rosu +/- Ezetimibe               Standard dose 

                                                        LDL-C < 1.8 mmol          40 mg Simvastatin

Duration of treatment (m)        12                                          12



Table 2
Treatment regime                      Intensive                               Conventional
Number of patients                    48                                           48
MACE                                     
            AMI                                   2                                              1
            Unstable Angina             6                                              8 
Vulnerable plaques                   10                                            8



http://ac.els-cdn.com/S0021915015013593/1-s2.0-S0021915015013593-main.pdf


And another disappointing result with different parameters:
http://eurheartj.oxfordjournals.org/content/early/2014/08/28/eurheartj.ehu373.full

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