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Cited by 147Atherosclerosis and Cardiovascular DiseasesLipoproteins and Cardiovascular HealthCoronary Interventions and Diagnostics

Relationship Between Atheroma Regression and Change in Lumen Size After Infusion of Apolipoprotein A-I Milano

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Nicholls, Stephen J., Tuzcu, E. Murat, Sipahi, Ilke, Schoenhagen, Paul, Crowe, Tim, Kapadia, Samir, Nissen, Steven E.·2006·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2005.11.040
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Abstract

Objectives The aim of this study was to determine the relationship between atheroma regression and arterial wall remodeling.Background Infusion of reconstituted high-density lipoprotein (rHDL) containing recombinant apolipoprotein A-I Milano (AIM) has been reported to promote rapid regression of coronary atherosclerosis. The current study analyzed intravascular ultrasound (IVUS) to define the changes that take place in the arterial wall that accompanied atheroma regression in this study.Methods Forty-seven patients, ages 30 to 75 years, after an acute coronary syndrome were randomized to receive five weekly infusions of placebo or rHDL containing either low- or high-dose AIM. External elastic membrane (EEM) and lumen volumes were compared between coronary IVUS studies at baseline and follow-up.Results In comparison with baseline, infusion of rHDL was associated with a 4.6% reduction in EEM volume. Lumen volume did not change. In 10-mm arterial subsegments with the greatest plaque burden at baseline, atheroma volume regressed by 10.9% with a similar reduction in EEM volume but with no change in lumen size. In contrast, EEM and atheroma volume did not change in the 10-mm segments containing the least plaque burden. The reduction in EEM in the most diseased segments was only apparent in subjects who underwent plaque regression. Reduction in EEM volume correlated with the decreased atheroma volume (r = 0.62), but there was no correlation between change in lumen size and change in plaque volume.Conclusions Remodeling of the arterial wall is a focal and heterogeneous process. After infusion of rHDL containing AIM, regression of coronary atherosclerosis is accompanied by reverse remodeling of the EEM, resulting in no change in luminal dimensions.

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  • In a randomized clinical trial in patients with acute coronary syndromes, five weekly doses of ETC-216 resulted in statistically significant regression of coronary atherosclerosis measured by serial intravascular ultrasound.

    “These studies led to the use of a formulation of ETC-216 in a randomized clinical trial (with a small sample size) in patients with acute coronary syndromes; five weekly doses of the formulation resulted in a statistically significant regression of coronary atherosclerosis measured by serial intravascular ultrasound examinations62,63 (FIG. 2a).”

    From Perspectives and opportunities for nanomedicine in the management of atherosclerosis (2011) · cites this paper as [63]

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Authors
Nicholls, S. J., Tuzcu, E. M., Sipahi, I., Schoenhagen, P., Crowe, T., Kapadia, S., & Nissen, S. E.
Affiliations
Cleveland Clinic (US)
Corresponding author
Nissen, Steven E.
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2006-03
Volume
47
Issue
5
Pages
992-997
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2005.11.040
OpenAlex
W2020769052
Cited by
147
References
31
Citations by year
2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 9 · 2017: 6 · 2016: 7 · 2015: 16 · 2014: 11 · 2013: 10 · 2012: 12
FWCI
4.50
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
Keywords
apolipoprotein A-I Milano, atheroma regression, coronary artery disease, arterial remodeling, external elastic membrane, lumen size, plaque burden, acute coronary syndrome, intravascular ultrasound
MeSH terms
Adult, Aged, Coronary Artery Disease, Coronary Vessels, Humans, Infusions, Intravenous, Male, Middle Aged, Phosphatidylcholines, Remission Induction, Apolipoprotein A-I, Ultrasonography, Interventional

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