A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography.
- Al'Aref SJ Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
- Su A Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
- Gransar H Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA.
- van Rosendael AR Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
- Rizvi A Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA.
- Berman DS Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA.
- Callister TQ Tennessee Heart and Vascular Institute, Hendersonville, TN, USA.
- DeLago A Capitol Cardiology Associates, Albany, NY, USA.
- Hadamitzky M Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany.
- Hausleiter J Medizinische Klinik I der Ludwig-Maximilians-Universität München, Munich, Germany.
- Al-Mallah MH King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King AbdulAziz Cardiac Center, Ministry of National Guard, Health Affairs, Riyadh, Saudi Arabia.
- Budoff MJ Department of Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USA.
- Kaufmann PA Department of Nuclear Medicine, University Hospital, Zurich, Switzerland and University of Zurich, Switzerland.
- Raff GL Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA.
- Chinnaiyan K Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA.
- Cademartiri F Cardiovascular Imaging Center, SDN IRCCS, Naples, Italy.
- Maffei E Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy.
- Villines TC Cardiology Service, Walter Reed National Military Center, Bethesda, MD, USA.
- Kim YJ Seoul National University Hospital, Seoul, South Korea.
- Leipsic J Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada.
- Feuchtner G Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
- Pontone G Centro Cardiologico Monzino, IRCCS Milan, Italy.
- Andreini D Centro Cardiologico Monzino, IRCCS Milan, Italy.
- Marques H UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal.
- de Araújo Gonçalves P UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal.
- Rubinshtein R Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
- Achenbach S Department of Cardiology, Friedrich-Alexander-University Erlangen-Nuremburg, Germany.
- Chang HJ Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
- Chow BJW Department of Medicine and Radiology, University of Ottawa, ON, Canada.
- Cury R Department of Radiology, Miami Cardiac and Vascular Institute, Miami, FL, USA.
- Lu Y Department of Healthcare Policy and Research, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
- Bax JJ Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
- Jones EC Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
- Peña JM Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
- Shaw LJ Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
- Min JK Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
- Lin FY Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA. Electronic address: fal9003@med.cornell.edu.
- 2019-02-13
Published in:
- Journal of cardiovascular computed tomography. - 2019
Coronary computed tomography angiography
Coronary plaque composition
Ezetimibe
Fibrate
Niacin
Non-statin therapy
Aged
Asia
Biomarkers
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Disease
Coronary Stenosis
Coronary Vessels
Cross-Sectional Studies
Drug Therapy, Combination
Dyslipidemias
Europe
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypolipidemic Agents
Lipids
Male
Middle Aged
North America
Plaque, Atherosclerotic
Predictive Value of Tests
Prevalence
Registries
Risk Factors
English
INTRODUCTION
Non-statin therapy (NST) is used as second-line treatment when statin monotherapy is inadequate or poorly tolerated.
OBJECTIVE
To determine the association of NST with plaque composition, alone or in combination with statins, in patients undergoing coronary computed tomography angiography (coronary CTA).
METHODS
From the multicenter CONFIRM registry, we analyzed individuals who underwent coronary CTA with known lipid-lowering therapy status and without prior coronary artery disease at baseline. We created a propensity score for being on NST, followed by stepwise multivariate linear regression, adjusting for the propensity score as well as risk factors, to determine the association between NST and the number of coronary artery segments with each plaque type (non-calcified (NCP), partially calcified (PCP) or calcified (CP)) and segment stenosis score (SSS).
RESULTS
Of the 27,125 subjects in CONFIRM, 4,945 met the inclusion criteria; 371 (7.5%) took NST. At baseline, patients on NST had more prevalent risk factors and were more likely to be on concomitant cardiac medications. After multivariate and propensity score adjustment, NST was not associated with plaque composition: NCP (0.07 increase, 95% CI: -0.05, 0.20; p = 0.26), PCP (0.10 increase, 95% CI: -0.10, 0.31; p = 0.33), CP (0.18 increase, 95% CI: -0.10, 0.46; p = 0.21) or SSS (0.45 increase, 95% CI: -0.02,0.93; p = 0.06). The absence of an effect of NST on plaque type was not modified by statin use (p for interaction > 0.05 for all).
CONCLUSION
In this cross-sectional study, non-statin therapy was not associated with differences in plaque composition as assessed by coronary CTA.
Non-statin therapy (NST) is used as second-line treatment when statin monotherapy is inadequate or poorly tolerated.
OBJECTIVE
To determine the association of NST with plaque composition, alone or in combination with statins, in patients undergoing coronary computed tomography angiography (coronary CTA).
METHODS
From the multicenter CONFIRM registry, we analyzed individuals who underwent coronary CTA with known lipid-lowering therapy status and without prior coronary artery disease at baseline. We created a propensity score for being on NST, followed by stepwise multivariate linear regression, adjusting for the propensity score as well as risk factors, to determine the association between NST and the number of coronary artery segments with each plaque type (non-calcified (NCP), partially calcified (PCP) or calcified (CP)) and segment stenosis score (SSS).
RESULTS
Of the 27,125 subjects in CONFIRM, 4,945 met the inclusion criteria; 371 (7.5%) took NST. At baseline, patients on NST had more prevalent risk factors and were more likely to be on concomitant cardiac medications. After multivariate and propensity score adjustment, NST was not associated with plaque composition: NCP (0.07 increase, 95% CI: -0.05, 0.20; p = 0.26), PCP (0.10 increase, 95% CI: -0.10, 0.31; p = 0.33), CP (0.18 increase, 95% CI: -0.10, 0.46; p = 0.21) or SSS (0.45 increase, 95% CI: -0.02,0.93; p = 0.06). The absence of an effect of NST on plaque type was not modified by statin use (p for interaction > 0.05 for all).
CONCLUSION
In this cross-sectional study, non-statin therapy was not associated with differences in plaque composition as assessed by coronary CTA.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.jcct.2019.01.015
- PMID 30745132
- Persistent URL
- https://roar.hep-bejune.ch/global/documents/266719
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