Effects of statin therapy on progression of mild noncalcified coronary plaque assessed by serial coronary computed tomography angiography: A multicenter prospective study.
Abstract
BACKGROUND
There are limited data assessing statin therapy in patients with nonobstructive coronary plaque on coronary computed tomography angiography (CCTA).
METHODS
Two hundred six consecutive patients with mild noncalcified plaque on CCTA were enrolled in this multicenter prospective observational study. Subjects were divided into 3 groups according to subsequent statin therapy: intensive statin therapy (n = 55), moderate statins (n = 85), and no statin (n = 66). Serial scans were performed after a median interval of 18 months. Low-attenuation plaque (LAP) volume, total plaque volume, and percent plaque volume were measured.
RESULTS
The LAP volume, total plaque volume, and percent plaque volume showed significant regression among intensive-statin compared with no-statin group (annualized changes: -7.1 ± 13.1 vs 0.9 ± 12.7 mm(3), P< .001; -16.4 ± 35.0 vs 12.3 ± 32.4 mm(3), P< .001; and -6.2% ± 11.8% vs 3.5% ± 12.1%, P< .001, respectively). Progression of LAP volume, total plaque volume, and percent plaque volume was retarded among moderate-statin compared with no-statin group (annualized changes: -2.8 ± 7.6 vs 0.9 ± 12.7 mm(3), P= .041; -0.1 ± 25.6 vs 12.3 ± 32.4 mm(3), P= .014; and -1.8% ± 11.2% vs 3.5% ± 12.1%, P= .006, respectively). On multivariable model predicting change in total plaque volume, higher baseline LAP volume, moderate statin therapy, and intensive statin therapy were each independent predictors of plaque regression (standardized coefficients: baseline LAP volume -0.36, P< .001; moderate statin -0.21, P= .004; intensive statin -0.36, P< .001, respectively).
CONCLUSIONS
This study suggests that statin treatment can retard progression and even induce regression of mild noncalcified coronary plaque. Patients with greater baseline LAP volume are more likely to benefit from statin therapy.
Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.Department of Radiology, Beijing Chaoyang Hospital, Affiliated to Capital University of Medical Science, Beijing 100020, China.Department of Radiology, Beijing Chaoyang Hospital, Affiliated to Capital University of Medical Science, Beijing 100020, China.Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.Department of Radiology, People's Liberation Army General Hospital, Beijing 100853, China.Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. Electronic address: blu@vip.sina.com. MeSH
AgedComputed Tomography AngiographyCoronary Artery DiseaseCoronary VesselsDisease ProgressionFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLipidsMaleMiddle AgedPlaque, AtheroscleroticProspective Studies
Pub Type(s)
Journal Article
Multicenter Study
Observational Study
