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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

Changes in fibrous volume between follow-up and baseline with statin therapy.Abbreviations: CI: confidence interval; SD: standard deviation.
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pone.0133433.g002: Changes in fibrous volume between follow-up and baseline with statin therapy.Abbreviations: CI: confidence interval; SD: standard deviation.

Mentions: There was a marked reduction in fibrous volume between baseline and follow-up (WMD: -2.37 mm3, 95% CI -4.01 to -0.74 mm3, I2 = 7%, P = 0.004; Fig 2), and a significant increase in DC volume (WMD: 0.89 mm3, 95% CI 0.70 to 1.08 mm3, I2 = 0%, P<0.00001, Fig 3). No significant change was seen in FF volume (WMD: -2.00 mm3, 95% CI -5.84 to 1.84 mm3, I2 = 85%, P = 0.31; S1 Fig) and NC volume (WMD: 0.11 mm3, 95% CI -0.39 to 0.60 mm3, I2 = 0, P = 0.67; S2 Fig). The funnel plots for the NC and DC volume analyses revealed no evidence of publication bias (S3A and S3B Fig). The funnel plots for the fibrous and FF volume analyses appeared asymmetric (S4A and S4B Fig). However, Egger’s test suggested a low probability of publication bias (P = 0.42 and P = 0.07, respectively).


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)

Changes in fibrous volume between follow-up and baseline with statin therapy.Abbreviations: CI: confidence interval; SD: standard deviation.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4520465&req=5

pone.0133433.g002: Changes in fibrous volume between follow-up and baseline with statin therapy.Abbreviations: CI: confidence interval; SD: standard deviation.
Mentions: There was a marked reduction in fibrous volume between baseline and follow-up (WMD: -2.37 mm3, 95% CI -4.01 to -0.74 mm3, I2 = 7%, P = 0.004; Fig 2), and a significant increase in DC volume (WMD: 0.89 mm3, 95% CI 0.70 to 1.08 mm3, I2 = 0%, P<0.00001, Fig 3). No significant change was seen in FF volume (WMD: -2.00 mm3, 95% CI -5.84 to 1.84 mm3, I2 = 85%, P = 0.31; S1 Fig) and NC volume (WMD: 0.11 mm3, 95% CI -0.39 to 0.60 mm3, I2 = 0, P = 0.67; S2 Fig). The funnel plots for the NC and DC volume analyses revealed no evidence of publication bias (S3A and S3B Fig). The funnel plots for the fibrous and FF volume analyses appeared asymmetric (S4A and S4B Fig). However, Egger’s test suggested a low probability of publication bias (P = 0.42 and P = 0.07, respectively).

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