Abstract 15473: Effect of Statins on Coronary Plaque Progression Assessed by Serial Coronary Computed Tomography Angiography

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Suraj Dahal ◽  
Suvasini Lakshmanan ◽  
Khadije Ahmad ◽  
Vahid Rezvanizadeh ◽  
Ahmed K Ghanem ◽  
...  

Introduction: Statins stabilize coronary plaques and reduce clinical events. However, it is unclear how statins change the total plaque burden and plaque morphology. Hypothesis: We aimed at investigating whether statin users have less coronary plaque progression compared to non-statins users. Methods: We identified 243 subjects undergoing serial computed tomography angiography, 163 taking statins and 80 who are not. Coronary plaque (total, calcified, non-calcified including fibrous, fibrous-fatty and low-attenuation plaque (LAP)) volume was measured using semi-automated plaque software (Qangio, Medis) and its change overtime between statins users and non-statins users was evaluated using Analysis of Covariance (ANCOVA) modeling adjusted for age, gender, diabetic status, presence of hypertension, past smoking use, and baseline plaque levels. Results: Subjects on statin therapy had higher body mass index, were more likely to be diabetic, had hyperlipidemia, and were past smokers. Median coronary artery calcium score was significantly lower in the statin group; p<0.034. Driven primarily by changes in fibrous plaque, those on statin therapy showed 25% less total plaque (P=0.013) and 31% less total non-calcified plaque (P=0.006) at follow-up than non-statin users. Conclusions: The current study indicates that statin use is associated with less progression of total plaque and total non-calcified plaque burden.

2019 ◽  
Vol 20 (6) ◽  
pp. 636-643 ◽  
Author(s):  
Markus Goeller ◽  
Balaji K Tamarappoo ◽  
Alan C Kwan ◽  
Sebastien Cadet ◽  
Frederic Commandeur ◽  
...  

Abstract Aims Increased attenuation of pericoronary adipose tissue (PCAT) around the proximal right coronary artery (RCA) from coronary computed tomography angiography (CTA) has been shown to be associated with coronary inflammation and improved prediction of cardiac death over plaque features. Our aim was to investigate whether PCAT CT attenuation is related to progression of coronary plaque burden. Methods and results We analysed CTA studies of 111 stable patients (age 59.2 ± 9.8 years, 77% male) who underwent sequential CTA (3.4 ± 1.6 years between scans) with identical acquisition protocols. Total plaque (TP), calcified plaque (CP), non-calcified plaque (NCP), and low-density non-calcified plaque (LD-NCP) volumes and corresponding burden (plaque volume × 100%/vessel volume) were quantified using semi-automated software. PCAT CT attenuation (HU) was measured around the proximal RCA, the most standardized method for PCAT analysis. Patients with an increase in NCP burden (n = 51) showed an increase in PCAT attenuation, whereas patients with a decrease in NCP burden (n = 60) showed a decrease {4.4 [95% confidence interval (CI) 2.6–6.2] vs. −2.78 (95% CI −4.6 to −1.0) HU, P < 0.0001}. Changes in PCAT attenuation correlated with changes in the burden of NCP (r = 0.55, P < 0.001) and LD-NCP (r = 0.24, P = 0.01); but not CP burden (P = 0.3). Increased baseline PCAT attenuation ≥−75 HU was independently associated with increase in NCP (odds ratio 3.07, 95% CI 1.4–7.0; P < 0.008) and TP burden on follow-up CTA. Conclusion PCAT attenuation measured from routine CTA is related to the progression of NCP and TP burden. This imaging biomarker may help to identify patients at increased risk of high-risk plaque progression and allow monitoring of beneficial changes from medical therapy.


2020 ◽  
Vol 36 (1) ◽  
pp. 14-23
Author(s):  
Kristian L. Funck ◽  
Ricardo P. J. Budde ◽  
Mette H. Viuff ◽  
Jan Wen ◽  
Jesper M. Jensen ◽  
...  

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