This study compared the effects of 12 months of treatment with darapladib (oral Lp-PLA2 inhibitor, 160 mg daily) or placebo on coronary atheroma deformability (IVUS-palpography) and plasma hs-CRP in 330 patients with angiographically documented coronary disease. Secondary end points included changes in necrotic core size (IVUS-radiofrequency), atheroma size (IVUS-greyscale), and blood biomarkers.
Background therapy was comparable between groups, with no difference in LDL-cholesterol at 12 months (placebo: 88±34 and darapladib: 84±31 mg/dL, p=0.37). In contrast, Lp-PLA2 activity was inhibited by 59% with darapladib (p0.001 versus placebo). After 12 months, there were no significant differences between groups in plaque deformability (p=0.22) or plasma hsCRP (p=0.35). In the placebo-treated group, however, necrotic core volume increased significantly (4.5±17.9 mm3, p=0.009), whereas darapladib halted this increase (-0.5±13.9 mm3, p=0.71), resulting in a significant treatment difference of -5.2 mm3 (p=0.012). These intra-plaque compositional changes occurred without a significant treatment difference in total atheroma volume (p=0.95).-European Society of Cardiology
