Statins use and coronary artery plaque composition: Results from the International Multicenter CONFIRM Registry

• Type of Material: Article
• Authors: Ryo Nakazato, Cedars-Sinai Medical Center; Heidi Gransar, Cedars-Sinai Medical Center; Daniel S. Berman, Cedars-Sinai Medical Center; Victor Y. Cheng, Cedars-Sinai Medical Center; Fay Y. Lin, Weill Cornell Medical Collegel; Stephan Achenbach, University of Giessen; Mouaz Al-Mallah, Wayne State University; Matthew J. Budoff, Harbor UCLA Medical Center; Filippo Cademartiri, Giovanni XXIII Hospital; Tracy Q. Callister, Tennessee Heart and Vascular Institute; Hyuk-Jae Chang, Severance Cardiovascular Hospital; Ricardo C. Cury, Baptist Cardiac and Vascular Institute; Kavitha Chinnaiyan, William Beaumont Hospital; Benjamin J.W. Chow, University of Ottawa; Augustin Delago, Capitol Cardiology Associates; Martin Hadamitzky, DeutschesHerzzentrumMunchen; Joerg Hausleiter, DeutschesHerzzentrumMunchen; Philipp Kaufmann, University Hospital, Zurich; Erica Maffei, Giovanni XXIII Hospital; Gilbert Raff, William Beaumont Hospital; Leslee J Shaw, Emory University; Todd C. Villines, Walter Reed National Medical Center; Allison Dunning, Weill Cornell Medical College and the New York Presbyterian Hospital; Gudrun Feuchtner, Medical University of Innsbruck; Yong-Jin Kim, Seoul National University Hospital; Jonathon Leipsic, University of British Columbia; James K. Min, Cedars-Sinai Medical Center
• Language: English
• Date: 2012-11-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Elsevier Ireland Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.atherosclerosis.2012.08.002
• Title of Journal or Parent Work: Atherosclerosis
• ISSN: 0021-9150
• Volume: 225
• Issue: 1
• Start Page: 148
• End Page: 153
• Keywords: LIPID-LOWERING THERAPY; Coronary artery disease; Lipid profile; Science & Technology; Peripheral Vascular Disease; Cardiac & Cardiovascular Systems; ATHEROSCLEROSIS; Coronary CTA; INTRAVASCULAR ULTRASOUND; Plaque composition; Statin; TRIAL; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; METAANALYSIS; Life Sciences & Biomedicine; DISEASE; PROGNOSTIC VALUE; PROGRESSION; CHOLESTEROL; Cardiovascular System & Cardiology
• Research Categories: Health Sciences, Public Health; Health Sciences, General; Health Sciences, Radiology

Abstract

Objective: The effect of statins on coronary artery plaque features beyond stenosis severity is not known. Coronary CT angiography (CCTA) is a novel non-invasive method that permits direct visualization of coronary atherosclerotic features, including plaque composition. We evaluated the association of statin use to coronary plaque composition type in patients without known coronary artery disease (CAD) undergoing CCTA. Methods: From consecutive individuals, we identified 6673 individuals (2413 on statin therapy and 4260 not on statin therapy) with no known CAD and available statin use status. We studied the relationship between statin use and the presence and extent of specific plaque composition types, which was graded as non-calcified (NCP), mixed (MP), or calcified (CP) plaque. Results: The mean age was 59 ± 11 (55% male). Compared to the individuals not taking statins, those taking statins had higher prevalence of risk factors and obstructive CAD. In multivariable analyses, statin use was associated with increased the presence of MP [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.27-1.68), p < 0.001] and CP (OR 1.54, 95% CI 1.36-1.74, p < 0.001), but not NCP (OR 1.11, 95% CI 0.96-1.29, p = 0.1). Further, in multivariable analyses, statin use was associated with increasing numbers of coronary segments possessing MP (OR 1.52, 95% CI 1.34-1.73, p < 0.001) and CP (OR 1.52, 95% CI 1.36-1.70, p < 0.001), but not coronary segments with NCP (OR 1.09, 95% CI 0.94-1.25, p = 0.2). Conclusion: Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium. The longitudinal effect of statins on coronary plaque composition warrants further investigation.