Paradoxical increase in lumen size during progression of coronary atherosclerosis: Observations from the REVERSAL trial

Ilke Sipahi, E. Murat Tuzcu, Paul Schoenhagen, Stephen J. Nicholls, Michael S. Chen, Timothy Crowe, Aaron B. Loyd, Samir Kapadia, Steven E. Nissen

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Relative changes in lumen size during progression and regression of coronary atherosclerosis remain largely unknown. We assessed these changes using serial intravascular ultrasound (IVUS). From the baseline IVUS interrogations of the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial, 210 focal coronary lesions with <50% angiographic stenosis were identified. Lesions were matched to the follow-up IVUS, performed after 18 months of treatment with atorvastatin 80 mg/day or pravastatin 40 mg/day. Changes in external elastic membrane (EEM) and lumen areas of lesions demonstrating progression and regression (i.e. increased and decreased atheroma area) were examined. In progressors (n = 128), there was 1.34 mm2 increase in EEM area for every 1 mm2 increase in atheroma area (r = 0.72, p < 0.0001). This resulted in 0.34 mm2 increase in lumen area for every 1 mm2 increase in atheroma area (r = 0.25, p = 0.004). In contrast, there was no significant change in lumen area with regression of disease (n = 82, r = -0.06, p = 0.59). Progression of coronary atherosclerosis can be associated with a paradoxical increase in lumen cross-sectional area, whereas regression is not associated with any change in lumen area. Measurement of changes in lumen size may not be an accurate method to study progression and regression of atherosclerotic lesions with <50% stenosis.

LanguageEnglish
Pages229-235
Number of pages7
JournalAtherosclerosis
Volume189
Issue number1
DOIs
Publication statusPublished - 1 Nov 2006
Externally publishedYes

Keywords

  • Atherosclerosis
  • Coronary artery disease
  • Intravascular ultrasound
  • Remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Sipahi, I., Tuzcu, E. M., Schoenhagen, P., Nicholls, S. J., Chen, M. S., Crowe, T., ... Nissen, S. E. (2006). Paradoxical increase in lumen size during progression of coronary atherosclerosis: Observations from the REVERSAL trial. Atherosclerosis, 189(1), 229-235. https://doi.org/10.1016/j.atherosclerosis.2005.12.006
Sipahi, Ilke ; Tuzcu, E. Murat ; Schoenhagen, Paul ; Nicholls, Stephen J. ; Chen, Michael S. ; Crowe, Timothy ; Loyd, Aaron B. ; Kapadia, Samir ; Nissen, Steven E. / Paradoxical increase in lumen size during progression of coronary atherosclerosis : Observations from the REVERSAL trial. In: Atherosclerosis. 2006 ; Vol. 189, No. 1. pp. 229-235.
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Sipahi, I, Tuzcu, EM, Schoenhagen, P, Nicholls, SJ, Chen, MS, Crowe, T, Loyd, AB, Kapadia, S & Nissen, SE 2006, 'Paradoxical increase in lumen size during progression of coronary atherosclerosis: Observations from the REVERSAL trial', Atherosclerosis, vol. 189, no. 1, pp. 229-235. https://doi.org/10.1016/j.atherosclerosis.2005.12.006

Paradoxical increase in lumen size during progression of coronary atherosclerosis : Observations from the REVERSAL trial. / Sipahi, Ilke; Tuzcu, E. Murat; Schoenhagen, Paul; Nicholls, Stephen J.; Chen, Michael S.; Crowe, Timothy; Loyd, Aaron B.; Kapadia, Samir; Nissen, Steven E.

In: Atherosclerosis, Vol. 189, No. 1, 01.11.2006, p. 229-235.

Research output: Contribution to journalArticle

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AU - Sipahi, Ilke

AU - Tuzcu, E. Murat

AU - Schoenhagen, Paul

AU - Nicholls, Stephen J.

AU - Chen, Michael S.

AU - Crowe, Timothy

AU - Loyd, Aaron B.

AU - Kapadia, Samir

AU - Nissen, Steven E.

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