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Clinical Summary

Coronary atherosclerotic plaques: Is long-term statin use effective?

Takeaway

  • Long-term use of statins showed good association with slower progression of overall coronary atherosclerosis volume, increased plaque calcification and reduced features of high-risk plaque.

Why this matters

  • Not much is known about the generalisability of intravascular ultrasonography data among lower risk population or advanced coronary disease or beyond 24 months.

Study design

  • Observational study of 1255 patients (statin-naive group, n=474; statin-receiving group, n=781) who underwent serial coronary computed tomography angiography.
  • Atherosclerotic plaques were assessed for percent diameter stenosis, percent atheroma volume (PAV), plaque composition, presence of high-risk plaque (HRP) and positive arterial remodelling or spotty calcifications.
  • Funding: National Research Foundation of Korea.

Key results

  • Overall, 2496 lesions in statin-receiving group and 1079 lesions in statin-naive group were observed.
  • Lesions in statin-receiving group showed slower rates of PAV progression (1.76±2.40 mm3 per year; P=.002) and higher progression of calcified PAV (1.27±1.54 mm3 per year; P<.001) vs statin-naive patients.
  • Statin-receiving patients showed low progression of noncalcified PAV (0.49±2.39 mm3 per year; P<.001) and annual incidence of new HRP features (0.9% per year; P<.001).
  • Statins showed reduced risk for annualised increase in noncalcified PV above the median (HR, 0.703; P<.001) and reduction in HRP development (HR, 0.670; P=.026).

Limitations

  • Risk for bias.
  • Observational study design.

References


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