Coronary disease & ACS

Intake of high-intensity statin after acute myocardial infarction assessed by direct drug concentration measurement: association with low-density lipoprotein cholesterol (LDL-C) response and coronary plaque modifications in the PACMAN-AMI trial

Eur J Prev CardiolPublished Prespecified sub-study of the PACMAN-AMI randomised controlled trial

Authors' conclusion

In the PACMAN-AMI trial, intake of high-intensity statin at 4 and 52 weeks post-AMI was excellent, with minimal statin intolerance.

Study context

Population
Patients with acute myocardial infarction (AMI) on protocol-mandated high-intensity statin (rosuvastatin or atorvastatin)255 with imaging and blood samples
Participants
300 patients
Comparison
Adherent vs non-adherent to high-intensity statin
Methodological detailspre-specified sub-study
  • Pre-specified sub-study

Primary result

As reported in the abstract

Non-adherence (no detectable statin) · 4 and 52 weeks

Non-adherent at 4 weeks

3

1.2%

Non-adherent at 52 weeks

5

2.0%

Reported statin intolerance within 52 weeks

four (1.3%)

Further findings

OutcomeAdherentNon-adherent
Changes in LDL-C and intracoronary imaging endpoints · 52 weeksNumerically greater reductions
LDL-C change−2.73 mmol/L+0.07 mmol/L
IVUS per cent atheroma volume change−1.54%−0.15%
NIRS maximum lipid core burden index change−60.60.0
OCT fibrous cap thickness change+48.53 µm+7.98 µm

Sensitivity analysis excluding non-adherent patients

Confirmed the robustness of the main study results

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Intake of high-intensity statin after acute myocardial infarction assessed by direct drug concentration measurement: association with LDL-C response and coronary plaque modifications in the PACMAN-AMI trial. Eur J Prev Cardiol. Published 12 August 2025. doi:10.1093/eurjpc/zwaf457

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