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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 dense calcium volume with statin therapy using stratified analysis based on the intensity of statin therapy.Abbreviations: CI: confidence interval; SD: standard deviation.
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pone.0133433.g007: Meta-analysis of changes in dense calcium volume with statin therapy using stratified analysis based on the intensity of statin therapy.Abbreviations: CI: confidence interval; SD: standard deviation.

Mentions: When stratifying studies according to the intensity of statin therapy, a significant reduction in fibrous volume was seen in the high-intensive statin therapy subgroup (WMD: -2.01 mm3, 95% CI -3.05 to -0.96 mm3, I2 = 0%, P = 0.0002; Fig 6), while the reduction in fibrous volume in the low-intensive statin therapy subgroup approached statistical significance (WMD: -3.51 mm3, 95% CI -7.04 to 0.03 mm3, I2 = 33%, P = 0.05). In addition, a substantial increase in DC volume was observed in the high-intensive statin therapy subgroup (WMD: 0.90 mm3, 95% CI 0.70 to 1.10 mm3, I2 = 0%, P< 0.00001; Fig 7), while the increase in absolute DC volume in the low-intensive statin therapy subgroup approached statistical significance (WMD: 0.78 mm3, 95% CI -0.01 to 1.56 mm3, I2 = 3%, P = 0.05). There was no significant change in FF and NC volumes in these two subgroups after statin treatment (S6A and S6B 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 dense calcium volume with statin therapy using stratified analysis based on the intensity of statin therapy.Abbreviations: CI: confidence interval; SD: standard deviation.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0133433.g007: Meta-analysis of changes in dense calcium volume with statin therapy using stratified analysis based on the intensity of statin therapy.Abbreviations: CI: confidence interval; SD: standard deviation.
Mentions: When stratifying studies according to the intensity of statin therapy, a significant reduction in fibrous volume was seen in the high-intensive statin therapy subgroup (WMD: -2.01 mm3, 95% CI -3.05 to -0.96 mm3, I2 = 0%, P = 0.0002; Fig 6), while the reduction in fibrous volume in the low-intensive statin therapy subgroup approached statistical significance (WMD: -3.51 mm3, 95% CI -7.04 to 0.03 mm3, I2 = 33%, P = 0.05). In addition, a substantial increase in DC volume was observed in the high-intensive statin therapy subgroup (WMD: 0.90 mm3, 95% CI 0.70 to 1.10 mm3, I2 = 0%, P< 0.00001; Fig 7), while the increase in absolute DC volume in the low-intensive statin therapy subgroup approached statistical significance (WMD: 0.78 mm3, 95% CI -0.01 to 1.56 mm3, I2 = 3%, P = 0.05). There was no significant change in FF and NC volumes in these two subgroups after statin treatment (S6A and S6B 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