Effects of high- versus low-intensity lipid-lowering treatment in patients undergoing serial coronary computed tomography angiography: results of the multi-center LOCATE study.
Agatston score
Atherosclerosis
Coronary artery disease
Low/high intensity lipid-lowering treatment
Multi-center
Non-calcified plaque
Serial plaque quantification
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
30 Jul 2024
30 Jul 2024
Historique:
received:
06
06
2024
accepted:
18
07
2024
medline:
31
7
2024
pubmed:
31
7
2024
entrez:
30
7
2024
Statut:
aheadofprint
Résumé
To evaluate the effects of lipid-lowering medications of different intensities on total, calcified, and non-calcified plaque volumes in patients undergoing serial cardiac computed tomography angiography (CCTA). Individuals with chronic coronary syndromes from 11 centers were included in a retrospective registry. Total, calcified, and non-calcified plaque volumes were quantified and the relative difference in plaque volumes between baseline and follow-up CCTA was calculated. The intensity of lipid-lowering treatment was designated as low, moderate, or high, based on current recommendations. Of 216 patients (mean age 63.1 ± 9.7 years), undergoing serial CCTA (median timespan = 824.5 [IQR = 463.0-1323.0] days), 89 (41.2%) received no or low-intensity lipid-lowering medications, and 80 (37.0%) and 47 (21.8%) moderate- and high-intensity lipid-lowering agents, respectively. Progression of total and non-calcified plaque was attenuated in patients on moderate-/high- versus those on no/low-intensity treatment and arrested in patients treated with high-intensity statins or PCSK9 inhibitors (p < 0.001). Halted increase of non-calcified plaque was associated with LDL-cholesterol reduction (p < 0.001), whereas calcified plaque mass and Agatston score increased irrespective of the lipid-lowering treatment (p = NS). The intensity of lipid-lowering therapy robustly predicted attenuation of non-calcified plaque progression as a function of the time duration between the two CCTA scans, and this was independent of age and cardiovascular risk factors (HR = 3.83, 95% CI = 1.81-8.05, p < 0.001). The LOCATE multi-center observational study shows that progression of non-calcified plaques, which have been previously described as precursors of acute coronary syndromes, can be attenuated with moderate-intensity, and arrested with high-intensity lipid-lowering therapy. DRKS00031954.
Identifiants
pubmed: 39080016
doi: 10.1007/s00392-024-02502-6
pii: 10.1007/s00392-024-02502-6
doi:
Banques de données
DRKS
['DRKS00031954']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Sorin Giusca
(S)
Moritz Schütz
(M)
Lukas D Weberling
(LD)
Ramona Schmitt
(R)
Stefan O Schoenberg
(SO)
Mustafa Kuru
(M)
Steffen Klömpken
(S)
Szilveszter Balint
(S)
Pal Maurovitch-Horvat
(P)
Johannes Görich
(J)
Mustafa Emami
(M)
Philipp A Kaufmann
(PA)
Patrick Doeblin
(P)
Natalia Solowjowa
(N)
Karl Jakob Weiss
(KJ)
Stefan Baumann
(S)
Ksenia Stach
(K)
Informations de copyright
© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Knuuti J, Wijns W, Saraste A et al (2020) 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 41(3):407–477
doi: 10.1093/eurheartj/ehz425
pubmed: 31504439
Moss AJ, Williams MC, Newby DE, Nicol ED (2017) The updated NICE guidelines: cardiac CT as the first-line test for coronary artery disease. Curr Cardiovasc Imaging Rep 10(5):15
doi: 10.1007/s12410-017-9412-6
pubmed: 28446943
pmcid: 5368205
Motoyama S, Ito H, Sarai M et al (2015) Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. J Am Coll Cardiol 66(4):337–346
doi: 10.1016/j.jacc.2015.05.069
pubmed: 26205589
Maurovich-Horvat P, Schlett CL, Alkadhi H et al (2012) The napkin-ring sign indicates advanced atherosclerotic lesions in coronary CT angiography. JACC Cardiovasc Imaging 5(12):1243–1252
doi: 10.1016/j.jcmg.2012.03.019
pubmed: 23236975
Bienstock S, Lin F, Blankstein R et al (2023) Advances in coronary computed tomographic angiographic imaging of atherosclerosis for risk stratification and preventive care. JACC Cardiovasc Imaging 16(8):1099–1115
doi: 10.1016/j.jcmg.2023.02.002
pubmed: 37178070
Gitsioudis G, Schussler A, Nagy E et al (2015) Combined assessment of high-sensitivity troponin T and noninvasive coronary plaque composition for the prediction of cardiac outcomes. Radiology 276(1):73–81
doi: 10.1148/radiol.15141110
pubmed: 25734549
Korosoglou G, Chatzizisis YS, Raggi P (2021) Coronary computed tomography angiography in asymptomatic patients: still a taboo or precision medicine? Atherosclerosis 317:47–49
doi: 10.1016/j.atherosclerosis.2020.12.001
pubmed: 33334549
Williams MC, Kwiecinski J, Doris M et al (2020) Low-attenuation noncalcified plaque on coronary computed tomography angiography predicts myocardial infarction: results from the multicenter SCOT-HEART trial (Scottish Computed Tomography of the HEART). Circulation 141(18):1452–1462
doi: 10.1161/CIRCULATIONAHA.119.044720
pubmed: 32174130
pmcid: 7195857
Stone NJ, Robinson JG, Lichtenstein AH et al (2014) 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63(25Pt B):2889–2934
doi: 10.1016/j.jacc.2013.11.002
pubmed: 24239923
Mach F, Baigent C, Catapano AL et al (2020) 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 41(1):111–188
doi: 10.1093/eurheartj/ehz455
pubmed: 31504418
Smit JM, van Rosendael AR, El Mahdiui M et al (2020) Impact of clinical characteristics and statins on coronary plaque progression by serial computed tomography angiography. Circ Cardiovasc Imaging 13(3):e009750
doi: 10.1161/CIRCIMAGING.119.009750
pubmed: 32160786
Park HB, Arsanjani R, Sung JM et al (2023) Impact of statins based on high-risk plaque features on coronary plaque progression in mild stenosis lesions: results from the PARADIGM study. Eur Heart J Cardiovasc Imaging 24(11):1536–1543
doi: 10.1093/ehjci/jead110
pubmed: 37232393
van Rosendael AR, van den Hoogen IJ, Gianni U et al (2021) Association of statin treatment with progression of coronary atherosclerotic plaque composition. JAMA Cardiol 6(11):1257–1266
doi: 10.1001/jamacardio.2021.3055
pubmed: 34406326
Iatan I, Guan M, Humphries KH, Yeoh E, Mancini GBJ (2023) Atherosclerotic coronary plaque regression and risk of adverse cardiovascular events: a systematic review and updated meta-regression analysis. JAMA Cardiol 8(10):937–945
doi: 10.1001/jamacardio.2023.2731
pubmed: 37647074
Sabatine MS, Giugliano RP, Keech AC et al (2017) Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 376(18):1713–1722
doi: 10.1056/NEJMoa1615664
pubmed: 28304224
Choi AD, Thomas DM, Lee J et al (2021) 2020 SCCT guideline for training cardiology and radiology trainees as independent practitioners (Level II) and advanced practitioners (Level III) in cardiovascular computed tomography: a statement from the society of cardiovascular computed tomography. JACC Cardiovasc Imaging 14(1):272–287
doi: 10.1016/j.jcmg.2020.09.004
pubmed: 33168479
Tesche C, Bauer MJ, Straube F et al (2022) Association of epicardial adipose tissue with coronary CT angiography plaque parameters on cardiovascular outcome in patients with and without diabetes mellitus. Atherosclerosis 363:78–84
doi: 10.1016/j.atherosclerosis.2022.10.006
pubmed: 36280469
Weichsel L, Giesen A, Andre F et al (2024) Comparison of two contemporary quantitative atherosclerotic plaque assessment tools for coronary computed tomography angiography: single-center analysis and multi-center patient cohort validation. Diagnostics (Basel) 14(2):154
doi: 10.3390/diagnostics14020154
pubmed: 38248031
Makhmudova U, Samadifar B, Maloku A et al (2023) Intensive lipid-lowering therapy for early achievement of guideline-recommended LDL-cholesterol levels in patients with ST-elevation myocardial infarction (“Jena auf Ziel”). Clin Res Cardiol 112(9):1212–1219
doi: 10.1007/s00392-022-02147-3
pubmed: 36602598
pmcid: 10449699
Investigators S-H, Newby DE, Adamson PD et al (2018) Coronary CT angiography and 5-year risk of myocardial infarction. N Engl J Med 379(10):924–933
doi: 10.1056/NEJMoa1805971
Hadamitzky M, Achenbach S, Al-Mallah M et al (2013) Optimized prognostic score for coronary computed tomographic angiography: results from the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter Registry). J Am Coll Cardiol 62(5):468–476
doi: 10.1016/j.jacc.2013.04.064
pubmed: 23727215
Chow BJ, Small G, Yam Y et al (2015) Prognostic and therapeutic implications of statin and aspirin therapy in individuals with nonobstructive coronary artery disease: results from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter Registry) registry. Arterioscler Thromb Vasc Biol 35(4):981–989
doi: 10.1161/ATVBAHA.114.304351
pubmed: 25676000
pmcid: 4376658
Nicholls SJ, Puri R, Anderson T et al (2016) Effect of evolocumab on progression of coronary disease in statin-treated patients: the GLAGOV randomized clinical trial. JAMA 316(22):2373–2384
doi: 10.1001/jama.2016.16951
pubmed: 27846344
Puri R, Nicholls SJ, Shao M et al (2015) Impact of statins on serial coronary calcification during atheroma progression and regression. J Am Coll Cardiol 65(13):1273–1282
doi: 10.1016/j.jacc.2015.01.036
pubmed: 25835438
Lee SE, Sung JM, Andreini D et al (2019) Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: the progression of atherosclerotic plaque determined by computed tomographic angiography imaging (PARADIGM) study. Eur Heart J Cardiovasc Imaging 20(11):1307–1314
doi: 10.1093/ehjci/jez022
pubmed: 30789215
pmcid: 6806249
Baumann S, Kettel L, Stach K et al (2022) Serial changes in coronary plaque formation using CT angiography in patients undergoing PCSK9-inhibitor therapy with 1-year follow-up. J Thorac Imaging 37(5):285–291
doi: 10.1097/RTI.0000000000000666
pubmed: 35797638
Packer DL, Mark DB, Robb RA et al (2019) Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: the CABANA randomized clinical trial. JAMA 321(13):1261–1274
doi: 10.1001/jama.2019.0693
pubmed: 30874766
pmcid: 6450284
Symons R, Morris JZ, Wu CO et al (2016) Coronary CT angiography: variability of CT scanners and readers in measurement of plaque volume. Radiology 281(3):737–748
doi: 10.1148/radiol.2016161670
pubmed: 27636027