PhD Scientific Days 2026

Poster Session 1.P - Cardiovascular Medicine and Research

Early Plaque Changes After Short-Term Intensive Statin Therapy: Initial Results From the INTENSE Trial

Name of the presenter

Száraz, Lili

Institute/workplace of the presenter

Medical Imaging Centre, Semmelweis University

Authors

Lili Száraz Dr.¹, Réka Sebestyén-Dósa, MD¹, Barnabás Baksa, MD¹, István Csulak, MD¹, Sámuel Beke, MD¹, Kristóf Nagy, MD¹, Béla Merkely, MD, PhD, DSc², Pál Maurovich-Horvat, MD, PhD, DSc¹
1: Medical Imaging Centre, Semmelweis University
2: Heart and Vascular Center, Semmelweis University

Text of the abstract

Introduction: The early effect of intensified statin therapy on coronary plaque morphology and physiology, particularly as quantified by photon-counting detector CT (PCD-CT), remains insufficiently characterized.
Aim: Therefore, we aim to assess the effect of the short-term intensified statin therapy on coronary anatomy, physiology, and plaque composition using PCD-CT.
Methods: INTENSE is a prospective, randomized, double-blind, placebo-controlled, single-center trial enrolling statin-naïve patients referred for coronary CT angiography (CCTA) due to stable chest pain, with at least mild coronary atherosclerosis and non-hemodynamically significant disease (FFR-CT ≥ 0.75). Participants were randomized to rosuvastatin 40 mg daily or a matching placebo. CCTA was performed at baseline and 3 months using PCD-CT with a standardized protocol. Coronary plaque assessment was quantified with dedicated software, including total plaque volume (TPV), non-calcified plaque volume (NCPV) and low attenuation plaque volume (LAP). The prespecified primary analysis compared the 3-month change in plaque burden between groups.
Results: Of 46 randomized participants, 29 completed the 3-month CCTA (mean age 55.8 ± 6.7 years; 11 % women). At 3 months, NCPV decreased significantly in the rosuvastatin group compared with placebo (Δ −72 mm³ [−11.2%] vs Δ −3 mm³ [−0.4%]; between-group ΔΔ −69 mm³; p = 0.003). Similarly, TPV showed a greater regression with rosuvastatin (Δ −98 mm³ [−10.6%] vs Δ −5 mm³ [−0.6%]; p = 0.002). Exploratory physiological metrics (including FFR-CT-derived parameters) showed no meaningful change with rosuvastatin versus placebo (Δ +0.00 vs Δ −0.00; p = 0.74), with follow-up lowest-vessel FFR-CT 0.80 vs 0.79 (p = 0.41). Treatment-emergent adverse events occurred in 1% vs 3%, with no cases of clinically significant laboratory marker elevation or myopathy requiring discontinuation.
Conclusions: In statin-naïve patients with stable chest pain undergoing PCD-CT CCTA, short-term high-intensity rosuvastatin was associated with early regression of coronary plaque burden, driven predominantly by reductions in NCPV and TPV. These findings support PCD-CT-based quantitative plaque assessment as a sensitive tool for detecting early treatment responses and may help define “statin responder” phenotypes for longer-term follow-up.
Funding: Supported by the SE250+ Funding Scheme