Serial coronary CT angiography-verified changes in plaque characteristics as an end point: Evaluation of effect of statin intervention

Kaori Inoue, Sadako Motoyama, Masayoshi Sarai, Takahisa Sato, Hiroto Harigaya, Tomonori Hara, Yoshihiro Sanda, Hirofumi Anno, Takeshi Kondo, Nathan D. Wong, Jagat Narula, Yukio Ozaki

研究成果: Article

115 引用 (Scopus)

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Objectives: This study sought to assess, by serial computed tomography angiography (CTA), the effect of statin treatment on coronary plaque morphology. Background: In addition to the assessment of luminal stenosis, CTA also allows characterization of plaque morphology. Large, positively remodeled plaques with large necrotic cores have been reported as indicators of plaque instability. Methods: CTA was performed in 32 patients (26 men, ages 64.3 ± 8.5 years). Of these, 24 received fluvastatin after the baseline study; 8 subjects who refused statin treatment were followed as the control subjects. Serial imaging was performed after a median interval of 12 months. All vessels were examined in every subject, and a 10-mm-long segment was identified for comparison before and after intervention. Total plaque volume, low attenuation plaque (LAP) volume, lumen volume, and remodeling index were calculated. Results: In the statin-treated patients, the total plaque volume (92.3 ± 37.7 vs. 76.4 ± 26.5 mm3, p < 0.01) and LAP volume (4.9 ± 7.8 vs. 1.3 ± 2.3 mm3, p = 0.01) were significantly reduced over time; however, there was no change in the lumen volume (63.9 ± 25.3 vs. 65.2 ± 26.2 mm3, p = 0.59). On the other hand, no change was observed in the CTA characteristics in the control subjects, including total plaque volume (94.4 ± 21.2 vs. 98.4 ± 28.6 mm3, p = 0.48), LAP volume (2.1 ± 3.0 vs. 2.3 ± 3.6 mm3, p = 0.91), and lumen volume (80.5 ± 20.7 vs. 75.0 ± 16.3 mm3, p = 0.26). The plaque volume change (-15.9 ± 22.2 vs. 4.0 ± 14.0 mm3, p = 0.01) and LAP volume change (-3.7 ± 7.0 vs. 0.2 ± 1.5 mm3, p < 0.01) were significantly greater in the statin than the control group. The lumen volume (1.3 ± 15.6 vs. -5.5 ± 13.1 mm3, p = 0.24) and remodeling index (-2.4 ± 6.8% vs. -0.3 ± 6.5%, p = 0.53) did not show the significant differences between the 2 groups. The decrease in the plaque volume was due to reduction in the LAP volume (R = 0.83, p < 0.01), and was not related to any changes in the lumen volume (R = 0.21, p = 0.24). Conclusions: This preliminary study suggests that serial CTA evaluation of coronary plaques allows for the assessment of interval change in the plaque morphology. Statin treatment results in decreases in the plaque and necrotic core volume. The features known to be associated with plaque instability.

元の言語English
ページ(範囲)691-698
ページ数8
ジャーナルJACC: Cardiovascular Imaging
3
発行部数7
DOI
出版物ステータスPublished - 01-01-2010

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Coronary Angiography
fluvastatin
Pathologic Constriction
Computed Tomography Angiography
Control Groups
Therapeutics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

これを引用

Inoue, Kaori ; Motoyama, Sadako ; Sarai, Masayoshi ; Sato, Takahisa ; Harigaya, Hiroto ; Hara, Tomonori ; Sanda, Yoshihiro ; Anno, Hirofumi ; Kondo, Takeshi ; Wong, Nathan D. ; Narula, Jagat ; Ozaki, Yukio. / Serial coronary CT angiography-verified changes in plaque characteristics as an end point : Evaluation of effect of statin intervention. :: JACC: Cardiovascular Imaging. 2010 ; 巻 3, 番号 7. pp. 691-698.
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title = "Serial coronary CT angiography-verified changes in plaque characteristics as an end point: Evaluation of effect of statin intervention",
abstract = "Objectives: This study sought to assess, by serial computed tomography angiography (CTA), the effect of statin treatment on coronary plaque morphology. Background: In addition to the assessment of luminal stenosis, CTA also allows characterization of plaque morphology. Large, positively remodeled plaques with large necrotic cores have been reported as indicators of plaque instability. Methods: CTA was performed in 32 patients (26 men, ages 64.3 ± 8.5 years). Of these, 24 received fluvastatin after the baseline study; 8 subjects who refused statin treatment were followed as the control subjects. Serial imaging was performed after a median interval of 12 months. All vessels were examined in every subject, and a 10-mm-long segment was identified for comparison before and after intervention. Total plaque volume, low attenuation plaque (LAP) volume, lumen volume, and remodeling index were calculated. Results: In the statin-treated patients, the total plaque volume (92.3 ± 37.7 vs. 76.4 ± 26.5 mm3, p < 0.01) and LAP volume (4.9 ± 7.8 vs. 1.3 ± 2.3 mm3, p = 0.01) were significantly reduced over time; however, there was no change in the lumen volume (63.9 ± 25.3 vs. 65.2 ± 26.2 mm3, p = 0.59). On the other hand, no change was observed in the CTA characteristics in the control subjects, including total plaque volume (94.4 ± 21.2 vs. 98.4 ± 28.6 mm3, p = 0.48), LAP volume (2.1 ± 3.0 vs. 2.3 ± 3.6 mm3, p = 0.91), and lumen volume (80.5 ± 20.7 vs. 75.0 ± 16.3 mm3, p = 0.26). The plaque volume change (-15.9 ± 22.2 vs. 4.0 ± 14.0 mm3, p = 0.01) and LAP volume change (-3.7 ± 7.0 vs. 0.2 ± 1.5 mm3, p < 0.01) were significantly greater in the statin than the control group. The lumen volume (1.3 ± 15.6 vs. -5.5 ± 13.1 mm3, p = 0.24) and remodeling index (-2.4 ± 6.8{\%} vs. -0.3 ± 6.5{\%}, p = 0.53) did not show the significant differences between the 2 groups. The decrease in the plaque volume was due to reduction in the LAP volume (R = 0.83, p < 0.01), and was not related to any changes in the lumen volume (R = 0.21, p = 0.24). Conclusions: This preliminary study suggests that serial CTA evaluation of coronary plaques allows for the assessment of interval change in the plaque morphology. Statin treatment results in decreases in the plaque and necrotic core volume. The features known to be associated with plaque instability.",
author = "Kaori Inoue and Sadako Motoyama and Masayoshi Sarai and Takahisa Sato and Hiroto Harigaya and Tomonori Hara and Yoshihiro Sanda and Hirofumi Anno and Takeshi Kondo and Wong, {Nathan D.} and Jagat Narula and Yukio Ozaki",
year = "2010",
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doi = "10.1016/j.jcmg.2010.04.011",
language = "English",
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pages = "691--698",
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Serial coronary CT angiography-verified changes in plaque characteristics as an end point : Evaluation of effect of statin intervention. / Inoue, Kaori; Motoyama, Sadako; Sarai, Masayoshi; Sato, Takahisa; Harigaya, Hiroto; Hara, Tomonori; Sanda, Yoshihiro; Anno, Hirofumi; Kondo, Takeshi; Wong, Nathan D.; Narula, Jagat; Ozaki, Yukio.

:: JACC: Cardiovascular Imaging, 巻 3, 番号 7, 01.01.2010, p. 691-698.

研究成果: Article

TY - JOUR

T1 - Serial coronary CT angiography-verified changes in plaque characteristics as an end point

T2 - Evaluation of effect of statin intervention

AU - Inoue, Kaori

AU - Motoyama, Sadako

AU - Sarai, Masayoshi

AU - Sato, Takahisa

AU - Harigaya, Hiroto

AU - Hara, Tomonori

AU - Sanda, Yoshihiro

AU - Anno, Hirofumi

AU - Kondo, Takeshi

AU - Wong, Nathan D.

AU - Narula, Jagat

AU - Ozaki, Yukio

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Objectives: This study sought to assess, by serial computed tomography angiography (CTA), the effect of statin treatment on coronary plaque morphology. Background: In addition to the assessment of luminal stenosis, CTA also allows characterization of plaque morphology. Large, positively remodeled plaques with large necrotic cores have been reported as indicators of plaque instability. Methods: CTA was performed in 32 patients (26 men, ages 64.3 ± 8.5 years). Of these, 24 received fluvastatin after the baseline study; 8 subjects who refused statin treatment were followed as the control subjects. Serial imaging was performed after a median interval of 12 months. All vessels were examined in every subject, and a 10-mm-long segment was identified for comparison before and after intervention. Total plaque volume, low attenuation plaque (LAP) volume, lumen volume, and remodeling index were calculated. Results: In the statin-treated patients, the total plaque volume (92.3 ± 37.7 vs. 76.4 ± 26.5 mm3, p < 0.01) and LAP volume (4.9 ± 7.8 vs. 1.3 ± 2.3 mm3, p = 0.01) were significantly reduced over time; however, there was no change in the lumen volume (63.9 ± 25.3 vs. 65.2 ± 26.2 mm3, p = 0.59). On the other hand, no change was observed in the CTA characteristics in the control subjects, including total plaque volume (94.4 ± 21.2 vs. 98.4 ± 28.6 mm3, p = 0.48), LAP volume (2.1 ± 3.0 vs. 2.3 ± 3.6 mm3, p = 0.91), and lumen volume (80.5 ± 20.7 vs. 75.0 ± 16.3 mm3, p = 0.26). The plaque volume change (-15.9 ± 22.2 vs. 4.0 ± 14.0 mm3, p = 0.01) and LAP volume change (-3.7 ± 7.0 vs. 0.2 ± 1.5 mm3, p < 0.01) were significantly greater in the statin than the control group. The lumen volume (1.3 ± 15.6 vs. -5.5 ± 13.1 mm3, p = 0.24) and remodeling index (-2.4 ± 6.8% vs. -0.3 ± 6.5%, p = 0.53) did not show the significant differences between the 2 groups. The decrease in the plaque volume was due to reduction in the LAP volume (R = 0.83, p < 0.01), and was not related to any changes in the lumen volume (R = 0.21, p = 0.24). Conclusions: This preliminary study suggests that serial CTA evaluation of coronary plaques allows for the assessment of interval change in the plaque morphology. Statin treatment results in decreases in the plaque and necrotic core volume. The features known to be associated with plaque instability.

AB - Objectives: This study sought to assess, by serial computed tomography angiography (CTA), the effect of statin treatment on coronary plaque morphology. Background: In addition to the assessment of luminal stenosis, CTA also allows characterization of plaque morphology. Large, positively remodeled plaques with large necrotic cores have been reported as indicators of plaque instability. Methods: CTA was performed in 32 patients (26 men, ages 64.3 ± 8.5 years). Of these, 24 received fluvastatin after the baseline study; 8 subjects who refused statin treatment were followed as the control subjects. Serial imaging was performed after a median interval of 12 months. All vessels were examined in every subject, and a 10-mm-long segment was identified for comparison before and after intervention. Total plaque volume, low attenuation plaque (LAP) volume, lumen volume, and remodeling index were calculated. Results: In the statin-treated patients, the total plaque volume (92.3 ± 37.7 vs. 76.4 ± 26.5 mm3, p < 0.01) and LAP volume (4.9 ± 7.8 vs. 1.3 ± 2.3 mm3, p = 0.01) were significantly reduced over time; however, there was no change in the lumen volume (63.9 ± 25.3 vs. 65.2 ± 26.2 mm3, p = 0.59). On the other hand, no change was observed in the CTA characteristics in the control subjects, including total plaque volume (94.4 ± 21.2 vs. 98.4 ± 28.6 mm3, p = 0.48), LAP volume (2.1 ± 3.0 vs. 2.3 ± 3.6 mm3, p = 0.91), and lumen volume (80.5 ± 20.7 vs. 75.0 ± 16.3 mm3, p = 0.26). The plaque volume change (-15.9 ± 22.2 vs. 4.0 ± 14.0 mm3, p = 0.01) and LAP volume change (-3.7 ± 7.0 vs. 0.2 ± 1.5 mm3, p < 0.01) were significantly greater in the statin than the control group. The lumen volume (1.3 ± 15.6 vs. -5.5 ± 13.1 mm3, p = 0.24) and remodeling index (-2.4 ± 6.8% vs. -0.3 ± 6.5%, p = 0.53) did not show the significant differences between the 2 groups. The decrease in the plaque volume was due to reduction in the LAP volume (R = 0.83, p < 0.01), and was not related to any changes in the lumen volume (R = 0.21, p = 0.24). Conclusions: This preliminary study suggests that serial CTA evaluation of coronary plaques allows for the assessment of interval change in the plaque morphology. Statin treatment results in decreases in the plaque and necrotic core volume. The features known to be associated with plaque instability.

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