Effect of High-Dose Statin Therapy on Drug-Eluting Stent Strut Coverage

Abstract

Objective— The influence of high-dose statin therapy on the serial stent healing process has not been fully investigated. Using optical coherence tomography, the effect of high-dose statin therapy on stent strut coverage was evaluated in drug-eluting stent–treated patients. Approach and Results— Sixty patients were randomly assigned to 2 groups according to the statin dose (atorvastatin 40 mg as high-dose statin therapy [n=29] versus pravastatin 20 mg as low-dose statin therapy [n=31]). Serial optical coherence tomographic evaluation post procedure and at the 3-month and 12-month follow-ups was performed in 50 patients with 54 stents (23 atorvastatin-treated patients versus 27 pravastatin-treated patients). The percentage of uncovered struts was defined as the ratio of uncovered struts/total struts. The primary end point was the percentage of uncovered struts at the 12-month follow-up. The secondary end point was the percentage of uncovered struts at the 3-month follow-up and the comparative percentage change (Δ) of uncovered struts at the 3- and 12-month follow-ups between the different dose statin therapies. The percentage of uncovered struts was 7.4% (range, 4.3%–10.4%) in atorvastatin-treated patients versus 10.6% (range, 5.7%–22.6%) in pravastatin-treated patients at the 3-month follow-up ( P =0.13) and 1.3% (0.3%–3.8%) versus 2.5% (0.9%–9.7%), respectively, at the 12-month follow-up ( P =0.01). The percentage Δ of uncovered struts from 3 to 12 months of follow-up was −7.9±8.5% in atorvastatin-treated patients versus −9.3±12.5% in pravastatin-treated patients ( P =0.67). Conclusions— This study suggested that high-dose statin therapy might provide a beneficial effect for the vascular healing process after drug-eluting stent implantation.