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Impact of Intensive LDL Cholesterol Lowering on Coronary Artery Atherosclerosis Progression: A Serial CT Angiography Study.
JACC Cardiovasc Imaging. 2017 04; 10(4):437-446.JC

Abstract

OBJECTIVES

The aim of this study was to explore the relationship between temporal changes in coronary plaque volume and the intensity of lipid-lowering treatments, utilizing coronary computed tomography angiography (CTA).

BACKGROUND

Coronary CTA has acceptable accuracy in terms of quantitative measurement of plaque volume. Although, coronary CTA is perhaps capable of identifying the differences in plaque volume progression according to the intensity of lipid lowering treatment, to date, few studies have examined this notion.

METHODS

In this multicenter, observational study, the authors reviewed 467 patients who underwent serial coronary CTA with a scan period of more than 2 years (median 3.2 years [2.4 to 4.8]) apart, and whose laboratory data were available within 1 month of both the baseline and follow-up coronary CTA. Among them, 147 patients (comprising 336 vessels) with visible plaque were enrolled in this study. The authors performed quantitative assessment of coronary plaque in both. Patients who achieved a low-density lipoprotein cholesterol (LDL-C) with a cut off value below 70 mg/dl at follow-up were compared with those who did not.

RESULTS

Patients with LDL-C below 70 mg/dl displayed a significant attenuation in plaque progression as compared with those with follow-up LDL-C levels ≥70 mg/dl (12.7 ± 38.2 mm3 vs. 44.2 ± 73.6 mm3, respectively; p = 0.014). In multivariate analysis, factors influencing plaque progression per year was follow-up LDL-C levels ≥70 mg/dl (beta 0.193; p = 0.021).

CONCLUSIONS

Strict LDL-C control appeared to significantly attenuate plaque volume progression based on noninvasive quantitative assessment by coronary CTA.

Authors+Show Affiliations

Division of Cardiology, Department of Internal Medicine, NHIS Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea; Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Myungji Hospital, Goyang-si, Gyeonggi-do, South Korea.Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea. Electronic address: hjchang@yuhs.ac.Mayo Clinic, Division of Cardiology, Department of Internal Medicine, Scottsdale, Arizona.Weill Cornell Medical College and the New York-Presbyterian Hospital, New York, New York.Division of Cardiology, Seoul National University Hospital, Seoul, South Korea.Division of Cardiology, Gangnam Severance Hospital, Seoul, South Korea.Division of Cardiology, Busan Medical Center, Busan, South Korea.Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27771404

Citation

Shin, Sanghoon, et al. "Impact of Intensive LDL Cholesterol Lowering On Coronary Artery Atherosclerosis Progression: a Serial CT Angiography Study." JACC. Cardiovascular Imaging, vol. 10, no. 4, 2017, pp. 437-446.
Shin S, Park HB, Chang HJ, et al. Impact of Intensive LDL Cholesterol Lowering on Coronary Artery Atherosclerosis Progression: A Serial CT Angiography Study. JACC Cardiovasc Imaging. 2017;10(4):437-446.
Shin, S., Park, H. B., Chang, H. J., Arsanjani, R., Min, J. K., Kim, Y. J., Lee, B. K., Choi, J. H., Hong, G. R., & Chung, N. (2017). Impact of Intensive LDL Cholesterol Lowering on Coronary Artery Atherosclerosis Progression: A Serial CT Angiography Study. JACC. Cardiovascular Imaging, 10(4), 437-446. https://doi.org/10.1016/j.jcmg.2016.04.013
Shin S, et al. Impact of Intensive LDL Cholesterol Lowering On Coronary Artery Atherosclerosis Progression: a Serial CT Angiography Study. JACC Cardiovasc Imaging. 2017;10(4):437-446. PubMed PMID: 27771404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Intensive LDL Cholesterol Lowering on Coronary Artery Atherosclerosis Progression: A Serial CT Angiography Study. AU - Shin,Sanghoon, AU - Park,Hyung-Bok, AU - Chang,Hyuk-Jae, AU - Arsanjani,Reza, AU - Min,James K, AU - Kim,Yong-Jin, AU - Lee,Byoung Kwon, AU - Choi,Jung-Hyun, AU - Hong,Geu-Ru, AU - Chung,Namsik, Y1 - 2016/10/19/ PY - 2016/02/19/received PY - 2016/04/01/revised PY - 2016/04/18/accepted PY - 2016/10/25/pubmed PY - 2017/10/27/medline PY - 2016/10/25/entrez KW - atherosclerosis KW - coronary computed tomography angiography KW - coronary plaque quantification KW - low-density lipoprotein-cholesterol SP - 437 EP - 446 JF - JACC. Cardiovascular imaging JO - JACC Cardiovasc Imaging VL - 10 IS - 4 N2 - OBJECTIVES: The aim of this study was to explore the relationship between temporal changes in coronary plaque volume and the intensity of lipid-lowering treatments, utilizing coronary computed tomography angiography (CTA). BACKGROUND: Coronary CTA has acceptable accuracy in terms of quantitative measurement of plaque volume. Although, coronary CTA is perhaps capable of identifying the differences in plaque volume progression according to the intensity of lipid lowering treatment, to date, few studies have examined this notion. METHODS: In this multicenter, observational study, the authors reviewed 467 patients who underwent serial coronary CTA with a scan period of more than 2 years (median 3.2 years [2.4 to 4.8]) apart, and whose laboratory data were available within 1 month of both the baseline and follow-up coronary CTA. Among them, 147 patients (comprising 336 vessels) with visible plaque were enrolled in this study. The authors performed quantitative assessment of coronary plaque in both. Patients who achieved a low-density lipoprotein cholesterol (LDL-C) with a cut off value below 70 mg/dl at follow-up were compared with those who did not. RESULTS: Patients with LDL-C below 70 mg/dl displayed a significant attenuation in plaque progression as compared with those with follow-up LDL-C levels ≥70 mg/dl (12.7 ± 38.2 mm3 vs. 44.2 ± 73.6 mm3, respectively; p = 0.014). In multivariate analysis, factors influencing plaque progression per year was follow-up LDL-C levels ≥70 mg/dl (beta 0.193; p = 0.021). CONCLUSIONS: Strict LDL-C control appeared to significantly attenuate plaque volume progression based on noninvasive quantitative assessment by coronary CTA. SN - 1876-7591 UR - https://www.unboundmedicine.com/medline/citation/27771404/Impact_of_Intensive_LDL_Cholesterol_Lowering_on_Coronary_Artery_Atherosclerosis_Progression:_A_Serial_CT_Angiography_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1936-878X(16)30622-2 DB - PRIME DP - Unbound Medicine ER -