{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:24:23Z","timestamp":1788535463731,"version":"build-2803163510"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018234","name":"Bern University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018234","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In real-world settings, adherence to preventive cardiovascular medications is often suboptimal. However, in clinical trials, adherence is crucial for ensuring the validity and generalizability of study results, and their clinical implications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Aims<\/jats:title>\n                    <jats:p>This pre-specified sub-study of the PACMAN-AMI randomized controlled trial investigated the intake of protocol-mandated high-intensity statin background therapy in patients with acute myocardial infarction (AMI), as assessed by direct measurement of rosuvastatin or atorvastatin blood concentrations at 4 and 52 weeks using liquid chromatography tandem mass spectrometry analysis. We evaluated the correlation between statin intake and changes in low-density lipoprotein cholesterol (LDL-C) levels, as well as multi-modality intracoronary imaging endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 300 enrolled patients, four (1.3%) reported statin intolerance within 52 weeks. Of 255 patients with completed imaging follow-up and available blood samples, 3 (1.2%) and 5 (2.0%) had no detectable statin concentrations at 4 and 52 weeks, respectively, and were classified as non-adherent. At 52 weeks, adherent patients demonstrated numerically greater reductions in LDL-C (\u22122.73 vs. +0.07\u2005mmol\/L), intravascular ultrasound-assessed per cent atheroma volume (\u22121.54% vs. \u22120.15%), and near-infrared spectroscopy-assessed maximum lipid core burden index (\u221260.6 vs. 0.0), with a higher increase in optical coherence tomography-assessed fibrous cap thickness (+48.53 vs. +7.98\u2005\u00b5m). Sensitivity analysis excluding non-adherent patients confirmed the robustness of the main study results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the PACMAN-AMI trial, intake of high-intensity statin at 4 and 52 weeks post-AMI was excellent, with minimal statin intolerance. These findings, along with the consistent sensitivity analysis, affirm the validity and reliability of the primary study conclusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov: NCT03067844<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf457","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T12:06:34Z","timestamp":1754654794000},"page":"2017-2030","source":"Crossref","is-referenced-by-count":1,"title":["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"],"prefix":"10.1093","volume":"33","author":[{"given":"Vera","family":"van der Velpen","sequence":"first","affiliation":[{"name":"Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010\u202f Bern, and Institute of Pharmacology, University of Bern , Inselspital, INO-F, Rosenb\u00fchlgasse 27, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas D","family":"H\u00e4ner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Kakizaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"B\u00e4r","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George C M","family":"Siontis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5076-0177","authenticated-orcid":false,"given":"Stefan","family":"Stortecky","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio G","family":"Biccir\u00e8","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Amb\u00fchl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital Basel , Petersgraben 4, 4031 Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan F","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital Geneva , Rue Gabrielle-Perret-Gentil 4, 1211 Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Mach","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Hospital Geneva , Rue Gabrielle-Perret-Gentil 4, 1211 Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J","family":"van Geuns","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Radboud UMC , Geert Grooteplein Zuid\u202f10, 6525\u202fGA Nijmegen ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8628-1410","authenticated-orcid":false,"given":"Joost","family":"Daemen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Erasmus University Medical Center , Dr. Molewaterplein\u202f40, 3015\u202fGD Rotterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Engstr\u00f8m","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, Copenhagen University Hospital , Inge Lehmanns Vej\u202f7, 2100 Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna S","family":"Ondracek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Vienna , W\u00e4hringer G\u00fcrtel\u202f18-20, 1090 Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Vienna , W\u00e4hringer G\u00fcrtel\u202f18-20, 1090 Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos V","family":"Bourantas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, St Bartholomew\u2019s Hospital, King George V Wing, West Smithfield, London EC1A 7BE and Device and Innovation Centre, William Harvey Research Institute, Queen Mary University London , Mile End Road, London E1 4NS ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian M","family":"Matter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zurich University Hospital , R\u00e4mistrasse\u202f100, 8091 Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2653-6762","authenticated-orcid":false,"given":"Stephan","family":"Windecker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos C","family":"Koskinas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, University of Bern , Heart and Vascular Center, Freiburgstrasse 20, Inselspital, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Mayr","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Faculty of Medicine, Imperial College London , Guy Scadding Building, Cale Street, London SW3 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