Does Statin Therapy Lower Coronary High-Intensity Plaque in CAD Patients?

Statins may significantly reduce the plaque-to-myocardium signal-intensity ratio (PMR) of high-intensity plaques, according to a study published July 13 in the Journal of the American College of Cardiology.

Researchers, led by Teruo Noguchi, MD, PhD, FACC, conducted the AQUAMARINE Pilot Study to assess the effect of statin (pitavastatin) therapy on PMR in coronary artery disease (CAD) patients over a 12-month follow-up period. All 96 participants were evaluated by non-contrast T1-weighted magnetic resonance imaging (MRI) and computed tomography angiography.

The results of the study showed that high-intensity plaque PMR was reduced in CAD patients treated with statins by 18.9 percent. Decreases in low-density lipoprotein-cholesterol (125 to 70 mg/dl) and high-sensitivity C-reactive protein were also seen in these patients. Control group participants had a 19.2 percent increase in PMR at 12-month follow-up compared to baseline.

The authors of the study further note that “non-contrast T1-weighted MRI can potentially be used for comparing plaque characteristics at different time points and may assist in assessing the efficacy of anti-atherosclerotic pharmacological interventions.”

“The current study is tantalizing but not confirmatory,” state Kazuyuki Yahagi, MD; Michael Joner, MD; and Renu Virmani, MD, FACC, in an accompanying editorial comment. “There are recognized pitfalls involving small cohorts together with further limitations of [MRI] because coronary arteries are barely visualized by this low-resolution modality.” 

Clinical Topics: Dyslipidemia, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Lipid Metabolism, Nonstatins, Novel Agents, Statins, Interventions and Coronary Artery Disease, Interventions and Imaging, Angiography, Magnetic Resonance Imaging, Nuclear Imaging

Keywords: Angiography, C-Reactive Protein, Cholesterol, Cholesterol, LDL, Control Groups, Coronary Artery Disease, Follow-Up Studies, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Lipoproteins, LDL, Magnetic Resonance Imaging, Myocardium, Pilot Projects, Plaque, Atherosclerotic, Quinolines, Tomography


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