Effect of statin therapy on the progression of coronary atherosclerosis

BMC Cardiovascular Disorders

Research Article

Yun Xiao¹  Xiang Ban²  Yanli Sun³  Bo Yu³  Xia Gu³  Jinwei Tian³  Sining Hu³ 

[1] Department of Bioinformatics, Harbin Medical University, Harbin, China;Department of Pathology, Harbin Medical University, Harbin, China;Key Laboratories of Education Ministry for Myocardial Ischemia; Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, 150086, Harbin, P.R. China;

关键词: Atherosclerosis;    Statin;    Meta-analysis;    Intravascular ultrasound;   

DOI  :  10.1186/1471-2261-12-70

 received in 2011-12-20, accepted in 2012-08-29,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundAn increasing number of authors employing intravascular ultrasound (IVUS) and virtual histology (VH-IVUS) have investigated the effect of statin use on plaque volume (PV) and plaque composition. However, inconsistent results have been reported. Therefore, we conducted a meta-analysis to determine the appropriate regimen of statins to effectively stabilize vulnerable coronary plaques.MethodsOnline electronic databases were carefully searched for all relevant studies. We compared mean values of PV and plaque composition between baseline and follow-up in patients receiving statin therapy. We pooled treatment effects and calculated mean differences (MD) with the 95% confidence interval (CI) using a random-effects model. By stratified analyses, we explored the influence of clinical presentation, dose and duration of statin treatment, and low-density lipoprotein-cholesterol (LDL-C) levels on the effects of statins.ResultsSeventeen studies involving 2,171 patients were analyzed. Statin therapy significantly decreased PV (−5.3 mm3; 95% CI: –3.3 mm3 to −7.2 mm3; P < 0.001), without heterogeneity. When considering the dose and duration of statins used, only subgroups employing a high dose and long duration demonstrated a significant reduction in PV (p < 0.001). A significant decrease in PV was noted if achieved LDL-C levels were <100 mg/dL (p < 0.001). Statin treatment could induce a twofold decrease in PV in patients with acute coronary syndrome (ACS) compared with that observed in patients with stable angina pectoris (SAP). A regressive trend was seen for necrotic core volume (MD: –2.1 mm3; 95% CI: –4.7 mm3 to 0.5 mm3, P = 0.11). However, statin use did not induce a significant change for fibrotic, fibro-fatty, or dense calcium compositions.ConclusionsOur meta-analysis demonstrated that statin therapy (especially that involving a high dose and long duration and achieving <100 mg/dL LDL-C levels) can significantly decrease PV in patients with SAP or ACS. These data suggested that statins can be used to reduce the atheroma burden for secondary prevention by appropriately selecting the statin regimen. No significant change in plaque composition was seen after statin therapy.

【 授权许可】

Unknown   
© Tian et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.