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Prior trials have demonstrated slowing or reversing of atherosclerosis progression with intensive statin therapy. But few studies have either assessed the ability of low dose statin treatment to achieve disease regression or the effect on vasa vasorum in humans.
Forty-three asymptomatic patients with fasting low-density lipoprotein cholesterol (LDL-C) ≥100 and ≤250 mg/dl and newly diagnosed 16% to 79% carotid stenosis by 3.0-T MRI were selected. No patients had taken statins prior to study enrollment. All of them received rosuvastatin 5 to 20 mg/d (mean 11 mg/d) to achieve targeted LDL-C level (<80 mg/dl). Serial lipid profile and carotid artery magnetic resonance imaging (MRI), including morphologic and dynamic contrast material-enhanced MR images, were obtained at baseline, 3 months, 12 months, and 24 months after treatment. The changes in plaque volume and %LRNC (lipid-rich necrotic core) were measured. The change in adventitia Vp (fractional plasma volume), shown as neovascular densities, was also evaluated.
After 24 months of treatment, 32 patients with matched serial MRI scans were analyzed. The baseline LDL-C level of 125.2 ± 24.4 mg/dl declined to 69.8 ± 16.6 mg/dl, a mean reduction of 42.2% (p < 0.001). Mean HDL-C level increased from 49.2 ± 14.7mg/dl to 53.8 ± 14.8 mg/dl, an increase of 10.3% (p < 0.001). There were no significant changes in plaque volume, with a moderate reduction of 0.3% (p > 0.05 vs. baseline). At 12 months, LRNC% significantly decreased from 18.9 ± 11.9% to 17.5 ± 11.2% (p < 0.05 vs. baseline), and to 16.7 ± 11.3% at 24 months (p < 0.05 vs. baseline). Reduction in adventitia Vp was found at 3 month therapy (0.09 ± 0.05 vs. baseline, p < 0.01). The same reduction occurred to 0.07 ± 0.04 (p < 0.01 vs. baseline) and 0.06 ± 0.05 (p < 0.05 vs. baseline) at 12 and 24 months, respectively.
Serial MRI assessments were firstly analyzed to investigate atherosclerosis regression in Chinese patients. These findings provide evidence that low dose statin therapy may have a beneficial effect on plaque volume, composition and vasa vasorum equal to intensive statin therapy from western population.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: MRI III – CMR in Myocardial Disease and Dysfunction
Abstract Category: 19. Imaging: MRI
Presentation Number: 1184-369
- 2013 American College of Cardiology Foundation