Lipid lowering therapy to modify plaque microstructures: Insights from optical coherence tomography imaging

Due to the pandemics of obesity and diabetes mellitus,especially in the western countries,atherosclerotic cardiovascular disease (ascvd) has become a major health burden and is expected to increase in the future. modifying lipid targets,especially low-density lipoprotein cholesterol (ldl-c) level,has become the first-line therapy for primary and secondary prevention of ascvd. intravascular imaging modalities have contributed to elucidating clinical efficacy of lipid lowering therapy on atherosclerotic plaques. optical coherence tomography (oct) is a high-resolution imaging tool enables visualization of plaque microstructures associated with its instability. this modality has demonstrated favorable changes in plaque microstructures under lowering ldl-c level. in addition,clinical studies using oct have suggested potential association of other lipid targets,including triglyceride and high-density lipoprotein cholesterol with plaque microstructures. given continuing cardiovascular risks despite statin therapy,oct will be an important imaging modality to evaluate novel therapeutic approaches that potentially modulates plaque instability. © 2017 japan atherosclerosis society.