Intensive statin therapy ‘stabilizes coronary plaques’
MedWire News: The composition and burden of non-calcified coronary atherosclerotic lesions (NCALs) is influenced by statin therapy, study findings suggest.
The researchers say that intensive statin therapy not only reduces the number of lipid-rich coronary plaques, but also inhibits potentially deleterious changes in vulnerable plaques.
Hideya Yamamoto (Hiroshima University Graduate School of Biomedical Sciences, Japan) and colleagues used 64-slice coronary computed tomography (CT) to assess NCALs in 114 consecutive patients with proven or suspected coronary artery disease.
The researchers’ aim was to investigate whether the characteristics of NCALs were influenced by statin therapy and serum lipid levels. At the time of examination, 24 participants were taking intensive statin therapy, 26 were taking moderate statin therapy, and 64 were not taking statins.
The study, which is reported in the International Journal of Cardiology, found that the prevalence of low-density NCALs – indicative of vulnerable lesions – was 46%, 58%, and 80% in the intensive-statin, moderate-statin, and no-statin groups, respectively.
Meanwhile, the prevalence of positive remodeling NCALs – also indicative of plaque vulnerability – was 54%, 58%, and 75% in the respective groups.
Correlation analysis revealed that the serum levels of low-density lipoprotein (LDL) cholesterol were inversely associated with plaque density, and that the number of low-density plaques was positively associated with the ratio of low-density to high-density lipoprotein cholesterol (LDL/HDL cholesterol).
Furthermore, in multivariate analysis, a LDL/HDL cholesterol ratio greater than 2.5 was an independent predictor of multiple low-density plaques, with an odds ratio of 2.39.
Yamamoto et al say that they have previously shown that 6 months’ statin treatment “is effective to stabilize vulnerable atherosclerotic plaques,” and that the current study suggests this effect is associated with changes in lipid levels.
However, they admit that other factors, such as inflammation, cigarette smoking, and use of other medications, particularly renin-angiotensin system blockers, may also be involved.
“Ongoing prospective trials… will monitor the effect of improving serum lipid profiles on coronary plaque stabilization, particularly with respect to the LDL/HDL cholesterol ratio and serum C-reactive protein levels,” they note.
The team concludes: “Cardiac CT angiography may prove a useful non-invasive modality for assessing the effects of lipid-lowering therapy on NCAL characteristics in patients with coronary artery disease.”
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By Joanna Lyford