1006-45 Regression of Infarct-Related Coronary Lesions on Aggressive Lipid Lowering Treatment in Patients After Recovery from Acute Myocardial Infarction

Abstract

Considering of remained active nature of infarct-related lesion (IRL) early after recovery from acute myocardial infarction (AMI), a prospective study was undertaken to determine whether IRL exhibits more regression on aggressive lipid lowering treatment. Fifty patients (pts), 34 hyperlipemic (HL) and 16 normal lipids (NL), aged ≤65 year with coronary diameter stenosis >25% were followed monthly. LDL-cholesterol (LDL-C) level was aimed to control below 130 mg/dl in HL patients on strict diet and pravastatin 10–30 mg/day, also LDL-apheresis in a patient with familier hyperlipemia. Repeat coronary angiography was performed in average 14 months after AMI onset, and altogether 142 lesions from 34 HL and 16 NL were analyzed quantitatively using cinedensitometry. Lesions which PTCA wire crossed were separately assessed. Average serum LDL-C levels improved from 166 to 117 mg/dl on drug and diet (p < 0.001) in HL. Seven out of 92 non-IRL (7.6%) exhibited progression defined as ≥0.5 mm decrease of minimum lesion diameter, and 9 IRL (9.8%) did regression ≥0.5 mm increase. Whereas thirty five IRL showed significantly more incidence of regression (9 sites, 25.7% p = 0.021) and similar rate of progression (3 pts, 8.6%). An improvement of LDL-C/HDL-C ratio was more prominent in patients with IRL regression compared with those showing progression or no change (p < 0.05). Thus the IRL was found in favor of more regression than non-IRL, and the magnitude of lesion regression can be expected according to the effect of lipid lowering treatment in patients after AMI.