国际心血管研究杂志

Statin Therapy is Associated with Reduction of Epicardial Adipose Tissues and Coronary Plaque Volumes with Vulnerable Composition, Measured by Computed Tomography Angiography

Naser Ahmadi, Vahid Nabavi, Jennifer Malpeso, Fereshteh Hajsadeghi, Hussain Ismaeel and Matthew Budoff

 Statin Therapy is Associated with Reduction of Epicardial Adipose Tissues and Coronary Plaque Volumes with Vulnerable Composition, Measured by Computed Tomography Angiography

Background: Increased coronary plaque volume and epicardialadipose-tissue (EAT) are independently predicting major-adversecardiovascular-events. This study evaluates the changes in EAT, total and composition-specific plaque-volume measured noninvasively by computed-tomography-angiography (CTA) in subjects with and without statin-therapy. Methods: This is a study of 106 consecutive-subjects (age 67 ± 9years, 80.7% men) who underwent serial clinically-indicated CTAs with median-interval of 1.2-year. Clinical and demographicfindings of 31 with statin-therapy and 75 without statin-therapy were evaluated. Changes in indexed total and composition-specific plaque-volume of target-segment with luminal-stenosis <50% as well as EAT, adipose-tissue inside pericardial-sac, were measured quantitatively. Results: At baseline, there was no significant difference in EAT, total and composition-specific plaque-volumes among subjects with and without statin-therapy (p>0.05). At follow-up, there were significant absolute-decrease in total plaque-volume (-38.2%) and EAT (-18.4%) in individuals with statin-therapy as compared to those without statin-therapy (p=0.0001). Similarly, significant decrease in non-calcified and mixed plaque-volume as well as lack of progression of calcified plaque-volume in statin-therapy group was noted (p<0.05). Risk adjusted median-decrease in total, mixed, calcified, non-calcified plaque-volumes, and EAT were 56%, 12%, 43%,144% and 76% more in statin-therapy as compared to those with diet-therapy (p<0.05). Furthermore, a significant directcorrelation between decrease in LDL-C and reduction in noncalcified plaque-volume (r2=0.64,p=0.0001) and decrease in EAT and non-calcified plaque-volume was noted (r2=0.69,p=0.0001). Conclusions: Statin therapy is associated with concomitant decreases in LDL-C, EAT and coronary plaque volumes especially non-calcified and mixed coronary plaques, which the latter suggesting plaque stabilization. This highlights that CTA can accurately and quantitatively measure the changes in EAT and coronary plaque volumes over time and monitor response to therapies.