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Fibrous cap thickness of the coronary plaque is indirectly proportional to the vulnerability of the plaque for rupture. Statin therapy is known to be associated with increase in the fibrous cap thickness. We therefore performed this meta-analysis to assess the change in fibrous cap thickness with statin therapy as assessed by optical coherence tomography (OCT).
Electronic search of PubMed, Google Scholar and EBSCO databases was performed to identify studies reporting fibrous cap thickness before and after statin therapy. Weighted mean difference (WMD) of the fibrous cap thickness as measured by OCT was then calculated using fixed or random effects model depending on the heterogeneity. Further, metaregression was performed using baseline characteristics, change in cholesterol levels and duration of therapy.
A total of 7 studies with 265 subjects were included in this analysis. Duration of therapy with statin varied from 3 - 12 months. The weighted mean difference of intimal thickness after statin therapy increased by 49 μm (95% CI 30.3 to 67.7). Metaregression did not show any correlation with baseline characteristics, change in cholesterol levels or duration of therapy.
Fibrous cap thickness as measured by OCT is remarkably increased after treatment with statins. The increase in thickness of fibrous cap was independent of underlying baseline characteristics, change in cholesterol levels and duration of therapy.
IMAGING: Imaging: Intravascular