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Impact of statin therapy on coronary plaque burden and composition assessed by coronary computed tomographic angiography: a systematic review and meta-analysis.
Eur Heart J Cardiovasc Imaging. 2018 08 01; 19(8):850-858.EH

Abstract

Aim

To clarify the potential role of coronary computed tomographic angiography (CCTA) in assessing the remodelling impact of statin therapy on plaque burden and compositions.

Methods and results

A systematic literature review and meta-analysis were conducted to examine the effect of statin therapy on different plaque volumes assessed by serial CCTA. Twelve studies were included with a mean (±standard deviation) follow-up period of 14.5 ± 9.5 months. Data on plaque volume were pooled using weighted mean difference method. Available data on a total of 199 intensive statin therapy receivers, 404 moderate statin therapy receivers and 189 controls (mean age = 62 ± 5 years, male gender = 78%) were meta-analysed. Intensive statin therapy reduced total plaque volume (TPV) by -20.87 [95% confidence interval (CI) -31.17, -10.56; P < 0.001] mm3, while moderate statin therapy reduced it by -1.67 (95% CI -9.99, 6.65; P = 0.69) mm3. In contrast TPV increased significantly in controls by 14.96 (95% CI 5.28, 24.64; P = 0.002) mm3. Percents of mean volume regression were -3.6% and -0.7% in intensive and moderate statin receivers, respectively, vs. +5.8% progression in controls. Statin therapy decreased non-calcified plaque volume by -7.62 (95% CI -17.38, 2.13; P = 0.124) mm3 and low attenuation plaque volume by -5.84 (95% CI -8.02, -3.66; P < 0.001) mm3. In statin therapy receivers, calcified plaque volume increased by 11.83 (95% CI 3.37, 20.29; P = 0.006) mm3 and calcium signal intensity increased by 21.99 (95% CI 9.2, 34.8; P < 0.001) Hounsfield units.

Conclusions

Initial studies demonstrated CCTA's possible role in evaluating the effect of statin therapy on plaque volume and composition. Further studies are warranted to delineate the mechanisms behind plaque changes.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, Glostrup University Hospital, Nordre Ringvej 57, 2600 Glostrup, Copenhagen, Denmark.Department of Cardiology, Aarhus University Hospital Skejby, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Department of Cardiology, Aarhus University Hospital Skejby, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.Division of Cardiology, Department of Medicine, Glostrup University Hospital, Nordre Ringvej 57, 2600 Glostrup, Copenhagen, Denmark.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

29617981

Citation

Andelius, Linn, et al. "Impact of Statin Therapy On Coronary Plaque Burden and Composition Assessed By Coronary Computed Tomographic Angiography: a Systematic Review and Meta-analysis." European Heart Journal Cardiovascular Imaging, vol. 19, no. 8, 2018, pp. 850-858.
Andelius L, Mortensen MB, Nørgaard BL, et al. Impact of statin therapy on coronary plaque burden and composition assessed by coronary computed tomographic angiography: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging. 2018;19(8):850-858.
Andelius, L., Mortensen, M. B., Nørgaard, B. L., & Abdulla, J. (2018). Impact of statin therapy on coronary plaque burden and composition assessed by coronary computed tomographic angiography: a systematic review and meta-analysis. European Heart Journal Cardiovascular Imaging, 19(8), 850-858. https://doi.org/10.1093/ehjci/jey012
Andelius L, et al. Impact of Statin Therapy On Coronary Plaque Burden and Composition Assessed By Coronary Computed Tomographic Angiography: a Systematic Review and Meta-analysis. Eur Heart J Cardiovasc Imaging. 2018 08 1;19(8):850-858. PubMed PMID: 29617981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of statin therapy on coronary plaque burden and composition assessed by coronary computed tomographic angiography: a systematic review and meta-analysis. AU - Andelius,Linn, AU - Mortensen,Martin Bødtker, AU - Nørgaard,Bjarne Linde, AU - Abdulla,Jawdat, PY - 2017/05/22/received PY - 2018/01/18/accepted PY - 2018/4/5/pubmed PY - 2019/3/29/medline PY - 2018/4/5/entrez SP - 850 EP - 858 JF - European heart journal cardiovascular Imaging JO - Eur Heart J Cardiovasc Imaging VL - 19 IS - 8 N2 - Aim: To clarify the potential role of coronary computed tomographic angiography (CCTA) in assessing the remodelling impact of statin therapy on plaque burden and compositions. Methods and results: A systematic literature review and meta-analysis were conducted to examine the effect of statin therapy on different plaque volumes assessed by serial CCTA. Twelve studies were included with a mean (±standard deviation) follow-up period of 14.5 ± 9.5 months. Data on plaque volume were pooled using weighted mean difference method. Available data on a total of 199 intensive statin therapy receivers, 404 moderate statin therapy receivers and 189 controls (mean age = 62 ± 5 years, male gender = 78%) were meta-analysed. Intensive statin therapy reduced total plaque volume (TPV) by -20.87 [95% confidence interval (CI) -31.17, -10.56; P < 0.001] mm3, while moderate statin therapy reduced it by -1.67 (95% CI -9.99, 6.65; P = 0.69) mm3. In contrast TPV increased significantly in controls by 14.96 (95% CI 5.28, 24.64; P = 0.002) mm3. Percents of mean volume regression were -3.6% and -0.7% in intensive and moderate statin receivers, respectively, vs. +5.8% progression in controls. Statin therapy decreased non-calcified plaque volume by -7.62 (95% CI -17.38, 2.13; P = 0.124) mm3 and low attenuation plaque volume by -5.84 (95% CI -8.02, -3.66; P < 0.001) mm3. In statin therapy receivers, calcified plaque volume increased by 11.83 (95% CI 3.37, 20.29; P = 0.006) mm3 and calcium signal intensity increased by 21.99 (95% CI 9.2, 34.8; P < 0.001) Hounsfield units. Conclusions: Initial studies demonstrated CCTA's possible role in evaluating the effect of statin therapy on plaque volume and composition. Further studies are warranted to delineate the mechanisms behind plaque changes. SN - 2047-2412 UR - https://www.unboundmedicine.com/medline/citation/29617981/Impact_of_statin_therapy_on_coronary_plaque_burden_and_composition_assessed_by_coronary_computed_tomographic_angiography:_a_systematic_review_and_meta_analysis_ L2 - https://academic.oup.com/ehjcimaging/article-lookup/doi/10.1093/ehjci/jey012 DB - PRIME DP - Unbound Medicine ER -