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[Effects of statin intervention on mild coronary plaque progression assessed by serial coronary CT angiography].

医学 他汀类 四分位间距 内科学 经皮冠状动脉介入治疗 心脏病学 阿托伐他汀 核医学 心肌梗塞
作者
Li Zn,Hou Zh,Kun Liu,Wang Zq,Yin Wh,Yuguang Gao,Xu Hy,Jiang Sl,Lyu B
出处
期刊:PubMed [National Institutes of Health]
卷期号:44 (6): 508-12
标识
DOI:10.3760/cma.j.issn.0253-3758.2016.06.010
摘要

To assess the effects of statin treatment on mild coronary plaque progression by serial coronary CT angiography.A total of 120 consecutive patients (74 men, ages(58.9±8.1)years) with mild (≤50%luminal narrowing and lesion length<20 mm) non-calcified plaque detected by coronary CT angiography during September 2012 and December 2013 were prospectively enrolled in this study.Subjects were divided into three groups: no statin (n=36), statin lowering LDL-C <50% (n=43), and statin lowering LDL-C ≥50%(n=41). Serial scans were performed after a median interval of 705 (interquartile range: 467, 803) days.Total plaque volume, percent plaque volume for both baseline and follow-up were measured.Baseline and follow-up data were compared.Compared with baseline, total plaque volume in no statin group showed increasing trend by the end of follow-up ((97.3±57.8) mm(3) vs. (82.2±57.7) mm(3,) P=0.075). However, no significant change was observed as for total plaque volume ((78.5±45.2) mm(3) vs.(77.6±50.5) mm(3), P=0.910) in the statin lowering LDL-C <50% group.Total plaque volume was significantly reduced by the end of follow-up ((61.5 ± 46.1) mm(3) vs.(77.7±48.1) mm(3), P=0.024) in the statin lowering LDL-C ≥50% group.Percent plaque volume in no statin group was significantly increased by the end of follow-up ((51.9±16.5)% vs.(45.9±12.8)%, P=0.036). However, no significant change was observed as for percent plaque volume ((49.1±13.7)% vs.(47.5±14.9)%, P=0.554) in the statin lowering LDL-C <50% group. Percent plaque volume was significantly reduced by the end of follow-up ((39.1±17.1)% vs.(48.2±15.0)%, P=0.003) in the statin lowering LDL-C ≥50% group. Multivariable linear regression analysis showed that both higher baseline total plaque volume(β=-0.50, P<0.001) and statin lowering LDL-C ≥50%(β=-0.32, P=0.001) were independent determinants of plaque regression.This study suggests that LDL-C reduction ≥50% post statin treatment can retard plaque progression, and even induce regression of mild non-calcified coronary plaque, patients with greater baseline coronary plaque volume are more likely to benefit from statin therapy.
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