Effect of Rosuvastatin and Eicosapentaenoic Acid on Neoatherosclerosis: The LINK-IT Trial.

AIMS We assessed the effect of 10 mg/day of rosuvastatin plus eicosapentaenoic acid (EPA) versus 2.5 mg/day of rosuvastatin on the extent of neoatherosclerosis using optical coherence tomography (OCT). METHODS AND RESULTS We randomly assigned 50 patients with non-obstructive neoatherosclerotic plaques detected on OCT to receive either rosuvastatin 10 mg/day and EPA 1800 mg/day (intensive-therapy group) or rosuvastatin 2.5 mg (standard-therapy group). Follow-up OCT was performed 1 year later to evaluate serial changes of neoatherosclerosis. Serum low-density lipoprotein cholesterol (LDL-C) level decreased significantly from baseline to the 12-month follow-up in the intensive-therapy group (89 mg/dL to 70 mg/dL; P < 0.001), while no change occurred in the standard-therapy group. Lipid index change and percent changes in macrophage grade were significantly lower in the intensive-therapy group than in the standard-therapy group (-53.6 vs. 310.1, P = 0.001; -37.0% vs. 35.3%, P < 0.001; respectively). Percent changes in lipid index and macrophage grade were positively correlated with the changes in serum LDL-C and C-reactive protein levels, and negatively correlated with the change in serum eicosapentaenoic acid/arachidonic acid and 18-hydroxyeicosapentaenoic acid (EPA bioactive metabolite) level. CONCLUSIONS Compared with rosuvastatin 2.5 mg/day, rosuvastatin 10 mg/day and EPA 1800 mg/day significantly stabilized non-obstructive neoatherosclerotic plaques.