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Author Notes:

Corresponding author. Cedars-Sinai Heart Institute, 8700 Beverly Boulevard, S. Mark Taper Building, Suite 1253, Los Angeles, CA 90048, USA. Tel.: +1 310 423 2707; fax: +1 310 423 0811. Ryo.Nakazato@cshs.org (R. Nakazato), James.Min@cshs.org (J.K. Min)

Acknowledgements: None

Conflicts of interest: Dr. Min received modest speakers’ bureau and medical advisory board compensation and significant research support from GE Healthcare.

Dr. Achenbach received grant support from Siemens and Bayer Schering Pharma and has served as a consultant for Servier.

Dr. Al-Mallah received support from the American Heart Association, BCBS Foundation of Michigan, and Astellas.

Dr. Cademartiri received grant support from GE Healthcare and has served on the Speakers’ Bureau of Bracco and as a consultant for Servier; Dr. Maffei received grant support from GE Healthcare.

Dr. Chinnaiyan received grant support from Bayer Pharma and Blue Cross Blue Shield Blue Care MI.

Dr. Chow received research and fellowship support from GE Healthcare, research support from Pfizer and AstraZeneca, and educational support from TeraRecon.

Dr. Hausleiter received a research grant from Siemens Medical Systems.

Dr. Kaufmann received institutional research support from GE Healthcare and grant support from Swiss National Science Foundation.

Dr. Maffei received grant support from GE Healthcare Dr. Raff received grant support from Siemens, Blue Cross Blue Shield Blue Care MI, and Bayer Pharma.

All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.



  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Peripheral Vascular Disease
  • Cardiovascular System & Cardiology
  • Statin
  • Plaque composition
  • Coronary CTA
  • Coronary artery disease
  • Lipid profile

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

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Journal Title:



Volume 225, Number 1


, Pages 148-153

Type of Work:

Article | Post-print: After Peer Review


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.

Copyright information:

© 2012 Elsevier Ireland Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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