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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

Meta-analysis of changes in fibrous volume with statin therapy using stratified analysis based on follow-up duration.Abbreviations: CI: confidence interval; SD: standard deviation.
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pone.0133433.g004: Meta-analysis of changes in fibrous volume with statin therapy using stratified analysis based on follow-up duration.Abbreviations: CI: confidence interval; SD: standard deviation.

Mentions: When stratifying studies according to follow-up duration, the fibrous volume was substantially decreased in the subgroup with ≥12 months follow-up (WMD: -3.39 mm3, 95% CI -6.56 to -0.21 mm3, I2 = 41%, P = 0.04; Fig 4), while no significant change was observed in the subgroup with < 12 months follow-up (WMD: -1.73 mm3, 95% CI -6.44 to 2.98 mm3, I2 = 0, P = 0.47). The absolute DC volume was also significantly increased in the subgroup with ≥12 months follow-up (WMD: 0.99 mm3, 95% CI 0.23 to 1.76 mm3, I2 = 10%, P = 0.01; Fig 5), while no change was observed in the subgroup with < 12 months follow-up (WMD: 0.60 mm3, 95% CI -0.22 to 1.42 mm3, I2 = 0%, P = 0.15). There were no substantial changes in FF and NC volumes in the two subgroups after statin therapy (S5A and S5B Fig).


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)

Meta-analysis of changes in fibrous volume with statin therapy using stratified analysis based on follow-up duration.Abbreviations: CI: confidence interval; SD: standard deviation.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4520465&req=5

pone.0133433.g004: Meta-analysis of changes in fibrous volume with statin therapy using stratified analysis based on follow-up duration.Abbreviations: CI: confidence interval; SD: standard deviation.
Mentions: When stratifying studies according to follow-up duration, the fibrous volume was substantially decreased in the subgroup with ≥12 months follow-up (WMD: -3.39 mm3, 95% CI -6.56 to -0.21 mm3, I2 = 41%, P = 0.04; Fig 4), while no significant change was observed in the subgroup with < 12 months follow-up (WMD: -1.73 mm3, 95% CI -6.44 to 2.98 mm3, I2 = 0, P = 0.47). The absolute DC volume was also significantly increased in the subgroup with ≥12 months follow-up (WMD: 0.99 mm3, 95% CI 0.23 to 1.76 mm3, I2 = 10%, P = 0.01; Fig 5), while no change was observed in the subgroup with < 12 months follow-up (WMD: 0.60 mm3, 95% CI -0.22 to 1.42 mm3, I2 = 0%, P = 0.15). There were no substantial changes in FF and NC volumes in the two subgroups after statin therapy (S5A and S5B Fig).

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