Effects of statin therapy on non-calcified coronary plaque assessed by 64-slice computed tomography
International Journal of Cardiology,  Clinical Article

Kitagawa T et al. – This Computed tomography angiography (CTA) findings demonstrate that low–density NCALs occur less frequently in patients with intensive statin pre–treatment. A high LDL–C/HDL–C ratio is also associated with larger numbers of low–density NCALs.

Methods
  • Among 493 consecutive patients who underwent coronary CTA, authors enrolled 114 patients with NCALs.
  • Authors divided the patients into three groups according to preceding statin therapy: intensive statins (IS, n=24), moderate statins (MS, n=26), and no statin (NS, n=64).
  • The vulnerability of each NCAL was evaluated by density (low–density plaque defined as CT density ≤38HU), positive remodeling (remodeling index>1.05), and the presence of adjacent spotty calcification.

Results
  • Percentages of patients in the IS, MS, and NS groups with low–density NCALs were 46%, 58%, and 80%, respectively (p=0.009) and positive remodeling NCALs were 54%, 58%, and 75%, respectively (p=0.10).
  • Authors also found an inverse correlation between serum LDL–C level and the minimum plaque CT density.
  • According to the regression equation, a CT density of 38HU corresponded with LDL–C of 100mg/dl.
  • The number of low–density plaques was positively correlated with low–density to high–density lipoprotein cholesterol ratio (LDL–C/HDL–C).
  • An LDL–C/HDL–C>2.5 independently predicted multiple low–density plaques (OR 2.39 [95%CI: 1.28–4.86], p<0.001).

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