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The Effect of Statin Therapy on Coronary Plaque Composition Using Virtual Histology Intravascular Ultrasound: A Meta-Analysis.

Zheng G, Li Y, Huang H, Wang J, Hirayama A, Lin J - PLoS ONE (2015)

Bottom Line: There was a substantial reduction in fibrous volume between baseline and follow-up (WMD: -2.37 mm3, 95% confidence interval (CI) -4.01 to -0.74 mm3, P=0.004), and a significant increase in dense calcium (DC) volume (WMD: 0.89 mm3, 95% CI 0.70 to 1.08 mm3, P<0.00001).No significant change was seen in fibro-fatty and necrotic core (NC) volumes.In stratified analyses, the fibrous volume was decreased significantly (WMD: -3.39 mm3, 95% CI -6.56 to -0.21 mm3, P=0.04) and the absolute DC volume (WMD: 0.99 mm3, 95% CI 0.23 to 1.76 mm3, P=0.01) was increased in the subgroup with ≥12 months follow-up, whereas no significant change was observed in the subgroup with < 12 months follow-up.

View Article: PubMed Central - PubMed

Affiliation: The First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Cardiology, Zhangzhou Hospital Affiliated to Fujian Medical University, Fujian, China.

ABSTRACT

Objective: Previous studies have indicated that statin therapy may promote plaque regression. However, the impact of statin therapy on plaque composition has not been clearly elucidated. We performed a meta-analysis to investigate the effect of statin therapy on coronary plaque composition as assessed by virtual histology intravascular ultrasound (VH-IVUS).

Methods: Online databases were searched from inception to March 1, 2015. Studies providing VH-IVUS volumetric analyses of coronary plaque composition at baseline and follow-up in patients receiving statin therapy were included. Weighted mean difference (WMD) using a random-effects model was used.

Results: Ten studies involving 682 patients were included. There was a substantial reduction in fibrous volume between baseline and follow-up (WMD: -2.37 mm3, 95% confidence interval (CI) -4.01 to -0.74 mm3, P=0.004), and a significant increase in dense calcium (DC) volume (WMD: 0.89 mm3, 95% CI 0.70 to 1.08 mm3, P<0.00001). No significant change was seen in fibro-fatty and necrotic core (NC) volumes. In stratified analyses, the fibrous volume was decreased significantly (WMD: -3.39 mm3, 95% CI -6.56 to -0.21 mm3, P=0.04) and the absolute DC volume (WMD: 0.99 mm3, 95% CI 0.23 to 1.76 mm3, P=0.01) was increased in the subgroup with ≥12 months follow-up, whereas no significant change was observed in the subgroup with < 12 months follow-up. Similarly, a substantial decrease in fibrous volume (WMD: -2.01 mm3, 95% CI -3.05 to -0.96 mm3, P< 0.0002) and an increase in DC volume (WMD: 0.90 mm3, 95% CI 0.70 to 1.10 mm3, P< 0.00001) were observed in the subgroup with high-intensive statin therapy, while the change in fibrous and DC volumes approached statistical significance (P=0.05 and P=0.05, respectively) in the subgroup with low-intensive statin therapy.

Conclusions: Statin treatment, particularly of high-intensity and long-term duration, induced a marked modification in coronary plaque composition including a decrease in fibrous tissue and an increase in DC.

No MeSH data available.


Related in: MedlinePlus

Flow diagram showing the selection of studies for the meta-analysis.Abbreviations: IVUS: intravascular ultrasound.
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pone.0133433.g001: Flow diagram showing the selection of studies for the meta-analysis.Abbreviations: IVUS: intravascular ultrasound.

Mentions: The literature search identified 1339 potentially eligible publications. We screened the titles and abstracts for inclusion after removing duplicates and 39 studies were subject to full-text review. After detailed reviewing, 29 studies were excluded. Of these 29 excluded studies, four VH-IVUS studies [17–20] did not provide the absolute volume of plaque composition and were excluded. In total, ten studies were included in the present meta-analysis (Fig 1) [8–10,15,21–26].


The Effect of Statin Therapy on Coronary Plaque Composition Using Virtual Histology Intravascular Ultrasound: A Meta-Analysis.

Zheng G, Li Y, Huang H, Wang J, Hirayama A, Lin J - PLoS ONE (2015)

Flow diagram showing the selection of studies for the meta-analysis.Abbreviations: IVUS: intravascular ultrasound.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4520465&req=5

pone.0133433.g001: Flow diagram showing the selection of studies for the meta-analysis.Abbreviations: IVUS: intravascular ultrasound.
Mentions: The literature search identified 1339 potentially eligible publications. We screened the titles and abstracts for inclusion after removing duplicates and 39 studies were subject to full-text review. After detailed reviewing, 29 studies were excluded. Of these 29 excluded studies, four VH-IVUS studies [17–20] did not provide the absolute volume of plaque composition and were excluded. In total, ten studies were included in the present meta-analysis (Fig 1) [8–10,15,21–26].

Bottom Line: There was a substantial reduction in fibrous volume between baseline and follow-up (WMD: -2.37 mm3, 95% confidence interval (CI) -4.01 to -0.74 mm3, P=0.004), and a significant increase in dense calcium (DC) volume (WMD: 0.89 mm3, 95% CI 0.70 to 1.08 mm3, P<0.00001).No significant change was seen in fibro-fatty and necrotic core (NC) volumes.In stratified analyses, the fibrous volume was decreased significantly (WMD: -3.39 mm3, 95% CI -6.56 to -0.21 mm3, P=0.04) and the absolute DC volume (WMD: 0.99 mm3, 95% CI 0.23 to 1.76 mm3, P=0.01) was increased in the subgroup with ≥12 months follow-up, whereas no significant change was observed in the subgroup with < 12 months follow-up.

View Article: PubMed Central - PubMed

Affiliation: The First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China; Department of Cardiology, Zhangzhou Hospital Affiliated to Fujian Medical University, Fujian, China.

ABSTRACT

Objective: Previous studies have indicated that statin therapy may promote plaque regression. However, the impact of statin therapy on plaque composition has not been clearly elucidated. We performed a meta-analysis to investigate the effect of statin therapy on coronary plaque composition as assessed by virtual histology intravascular ultrasound (VH-IVUS).

Methods: Online databases were searched from inception to March 1, 2015. Studies providing VH-IVUS volumetric analyses of coronary plaque composition at baseline and follow-up in patients receiving statin therapy were included. Weighted mean difference (WMD) using a random-effects model was used.

Results: Ten studies involving 682 patients were included. There was a substantial reduction in fibrous volume between baseline and follow-up (WMD: -2.37 mm3, 95% confidence interval (CI) -4.01 to -0.74 mm3, P=0.004), and a significant increase in dense calcium (DC) volume (WMD: 0.89 mm3, 95% CI 0.70 to 1.08 mm3, P<0.00001). No significant change was seen in fibro-fatty and necrotic core (NC) volumes. In stratified analyses, the fibrous volume was decreased significantly (WMD: -3.39 mm3, 95% CI -6.56 to -0.21 mm3, P=0.04) and the absolute DC volume (WMD: 0.99 mm3, 95% CI 0.23 to 1.76 mm3, P=0.01) was increased in the subgroup with ≥12 months follow-up, whereas no significant change was observed in the subgroup with < 12 months follow-up. Similarly, a substantial decrease in fibrous volume (WMD: -2.01 mm3, 95% CI -3.05 to -0.96 mm3, P< 0.0002) and an increase in DC volume (WMD: 0.90 mm3, 95% CI 0.70 to 1.10 mm3, P< 0.00001) were observed in the subgroup with high-intensive statin therapy, while the change in fibrous and DC volumes approached statistical significance (P=0.05 and P=0.05, respectively) in the subgroup with low-intensive statin therapy.

Conclusions: Statin treatment, particularly of high-intensity and long-term duration, induced a marked modification in coronary plaque composition including a decrease in fibrous tissue and an increase in DC.

No MeSH data available.


Related in: MedlinePlus