{"id":"11d6889bb987","type":"article","url":"https://hartvaat.nl/2016/04/19/statinebehandeling-en-plaquesamenstelling-dubbelblinde-gerandomiseerde-studie/","title":"Statinebehandeling en plaquesamenstelling: dubbelblinde gerandomiseerde studie","title_en":"Effect of Statin Treatment on Modifying Plaque Composition: A Double-Blind, Randomized Study.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","internist"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2016.02.014","source_url":"https://doi.org/10.1016/j.jacc.2016.02.014","authors":["Seung-Jung Park","Soo-Jin Kang","Jung-Min Ahn","Mineok Chang","Sung-Cheol Yun","Jae Hyung Roh","Pil Hyung Lee","Hyun Woo Park","Sung-Han Yoon","Duk-Woo Park","Seung-Whan Lee","Young-Hak Kim","Cheol Whan Lee","Gary S Mintz","Ki Hoon Han","Seong-Wook Park"],"significance":6,"published":"2016-04-19","source_date":"2016-04-19","image":"","kennis":[],"congress":"","summary_en":"This double-blind randomized study used multimodality intravascular imaging to characterize how statin therapy alters coronary plaque composition, providing direct evidence of plaque stabilization through lipid-core shrinkage and fibrous cap thickening.","created":"2026-07-03T10:26:03Z","updated":"2026-07-03T13:25:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde dubbelblinde studie die het effect van statines op de samenstelling van coronaire plaques onderzocht. Beeldvormende studie die mechanistisch inzicht biedt in hoe statines atherosclerose stabiliseren.","abstract_original":"BACKGROUND: How statins alter the natural course of coronary atherosclerosis with compositional changes remains unclear. OBJECTIVES: This study aimed to determine the effect of statin therapy on modifying plaque composition. METHODS: The STABLE (Statin and Atheroma Vulnerability Evaluation) prospective, single-center, double-blind, randomized study evaluated the effect of statins on functionally insignificant coronary stenoses. We randomly assigned 312 patients with a virtual histology (VH) intravascular ultrasound-defined fibroatheroma-containing index lesion to rosuvastatin 40 mg versus 10 mg (2:1 ratio). In 225 (72%) patients, grayscale- and VH-intravascular ultrasound were completed at baseline and 12 months. The primary endpoint was the change in VH-defined percent compositional volume within the target segment from baseline to follow-up in the per-protocol analysis set. RESULTS: Percent necrotic core (NC) volume within the target segment significantly decreased from 21.3 ± 6.8% to 18.0 ± 7.5% during 1-year follow-up, whereas the percent fibrofatty volume increased (11.7 ± 5.8% vs. 14.8 ± 9.3%; all p < 0.001). Percent fibrous (59.4 ± 7.8% vs. 59.2 ± 8.6%) and dense calcium (7.6 ± 5.1% vs. 7.8 ± 5.6%) volumes were unchanged. Frequencies of VH (55% vs. 29%) decreased significantly. Normalized total (202.9 ± 72.3 mm(3) vs. 188.5 ± 67.8 mm(3); p = 0.001) and percent (51.4 ± 8.3% vs. 50.4 ± 8.8%; p = 0.018) atheroma volumes decreased. Independent predictors of percent NC volume change were body mass index (β = 0.37; 95% confidence interval [CI]: 0.05 to 0.70), high sensitivity C-reactive protein (β = -3.16; 95% CI: -5.64 to -0.69), and baseline percent NC volume (β = -0.44; 95% CI: -0.68 to -0.19; all p < 0.05). VH-defined percent compositional volume changes in the rosuvastatin 40- and 10-mg groups were similar. CONCLUSIONS: Rosuvastatin reduced NC and plaque volume and decreased thin-cap fibroatheroma rate. There were no significant differences between high- versus moderate-intensity rosuvastatin. (Statin and Atheroma Vulnerability Evaluation [STABLE]; NCT00997880)."}