P1774Effect of early pitavastatin therapy on coronary fibrous-cap thickness assessed by optical coherence tomography in patients with acute coronary syndrome: the ESCORT study

Background: Statins can contribute to the stabilization of coronary plaques. Purpose: The aim of the present study was to assess the effect of early statin therapy on fibrous cap thickness in coronary plaques of acute coronary syndrome (ACS) patients by using optical coherence tomography (OCT). Methods: This is a prospective, randomized, active-controlled, single-center study. Patients with ACS and untreated dyslipidemia were enrolled and randomly allocated (ratio 1:1) to either the early statin group (received pitavastatin 4 mg/day from baseline) or the late statin group (received pitavastatin 4 mg/day from 3 weeks after the baseline). OCT was performed at baseline, 3-week, and 36-week follow-up to assess non-culprit coronary plaques in 53 patients. Results: Between baseline and 3-week follow-up, fibrous cap thickness increased in the early statin group (values are median [interquartile range]) (140μm [120 to 170μm] to 160μm [130 to 190μm], p=0.017) but decreased in the late statin group (135μm [110 to 183μm] to 130μm [108 to 160μm], p=0.020). The percentage of increase in fibrous cap thickness between baseline and 3-week follow-up was significantly greater in the early statin group compared with the late statin group (8.3% [0% to 21.4%] vs. -5.8% [-16.0% to 0%], p<0.001). Between baseline and 36-week follow-up, fibrous cap thickness increased comparably in the two groups.