Monocyte count, HDL levels useful for predicting atherosclerotic regression
MedWire News: Japanese researchers have developed a model that could be used to predict coronary atherosclerotic plaque regression.
The model, which uses the change in patients' peripheral monocyte count and their serum high-density lipoprotein (HDL) cholesterol level as predictive factors, is useful because of the "inflammatory nature" of atherosclerosis, explain the authors in the journal Heart and Vessels.
Shigemasa Tani (Nihon University School of Medicine, Tokyo) and colleagues have previously shown that a decreased peripheral monocyte count and elevated serum HDL cholesterol level are independently involved in the effect of statins in promoting regression of coronary plaques.
To confirm this, the team assessed the coronary plaque volume of 114 coronary artery disease (CAD) patients who underwent percutaneous coronary intervention using volumetric intravascular ultrasound, at baseline and after 6 months of pravastatin therapy.
The researchers observed a significant 9.9% reduction in plaque volume after 6 months of treatment. Furthermore, serum HDL levels increased by 12.5% and the peripheral blood monocyte count decreased by 7.3%.
Regression analysis revealed that increases in serum HDL cholesterol and decreases in monocyte count were both independent predictors of plaque regression, and so the team used these factors to develop a predictive model.
The researchers report that, patients whose HDL cholesterol levels changed to become greater than or equal to the median of 8.8% and whose monocyte count changed to become less than or equal to the median of -8.6% showed the largest plaque regression, at 20.4%.
Conversely, patients whose HDL cholesterol levels were less than 8.8% and whose monocyte count increased above the median -8.6% after treatment showed the largest increase in plaque volume, at 2.6%.
"All the predictive factors for coronary plaque regression can be used as those for ischemic cardiac events," say Tani and team.
"Thus, the next target should be the application of the predictive model of coronary plaque regression with statins to cardiovascular events," they conclude.
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By Nikki Withers