Effect of lipid-lowering therapy with atorvastatin on atherosclerotic aortic plaques: a 2-year follow-up by noninvasive MRI

Yonemura, Atsushi; Momiyama, Yukihiko; Fayad, Zahi A.; Ayaori, Makoto; Ohmori, Reiko; Kihara, Teruyoshi; Tanaka, Norihiro; Nakaya, Kazuhiro; Ogura, Mariko; Taniguchi, Hiroaki; Kusuhara, Masatoshi; Nagata, Masayoshi; Nakamura, Haruo; Tamai, Susumu; Ohsuzu, Fumitaka

doi:10.1097/hjr.0b013e32832948a0

Cited by 29 publications

(24 citation statements)

References 20 publications

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“…Plaque regression in the thoracic aorta and retardation of plaque progression in the abdominal aorta by 1-year atorvastatin (20 mg versus 5 mg) have also been reported in an MRI prospective, randomised, open-label trial carried out in 36 hypercholesterolaemic patients [ 95 ]. After 2 years of treatment, regression of thoracic plaques was found in the 20 mg group (−15 % vessel wall area reduction), but not in the 5 mg group (+7 %).…”

Section: Statinsmentioning

confidence: 67%

Aortic Atherosclerosis as an Embolic Source

Baldassarre

Pepi

2014

Pharmacotherapy in Aortic Disease

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Section: Statinsmentioning

confidence: 67%

Aortic Atherosclerosis as an Embolic Source

Baldassarre

Pepi

2014

Pharmacotherapy in Aortic Disease

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“…Statin treatment has been shown to induce reduced progression or even regression of plaque burden. [19][20][21][22][23][24][25] Approximately 90% of patients in our study were using statins during the follow-up period. Thirty-one percent of our patients showed plaque regression, a number similar to that found in other plaque progression studies in which most patients were on statin therapy.…”

Section: Discussionmentioning

confidence: 99%

Carotid Atherosclerotic Plaque Progression and Change in Plaque Composition Over Time: A 5-Year Follow-Up Study Using Serial CT Angiography

Gils¹,

Vukadinovic²,

Dijk³

et al. 2012

AJNR Am J Neuroradiol

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“…In the other study, this regression was related to LDL lowering and the statin dosage [20]. A recent openlabeled randomized trial tested the effect of 20-mg versus 5-mg atorvastatin (N1=N2=18) on asymptomatic thoracic and abdominal aortic plaque measured by MRI, demonstrated a significant plaque regression over 2 years [21]. A more recent open-labeled randomized trial tested the effect of intensive (N=31) versus standard (N=29) rosuvastatin therapy based on LDL reduction also in asymptomatic thoracic and abdominal aortic plaque measured by MRI, demonstrated a significant plaque regression over one year [22].…”

Section: Discussionmentioning

confidence: 99%

Effect of stroke prevention medication on aortic atheroma progression assessed using new statistical paradigm

Rudra¹,

Sen²,

Dennis³

et al. 2016

J Med Stat Inform

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Background: Progression of aortic arch atheroma (AA) is associated with vascular events in patients with stroke or transient ischemic attack (TIA). Studies investigating effect of stroke prevention medication on AA progression are limited to post-cerebral segments that may not be related to stroke pathophysiology and do not use information from the relevant segments adjacent to the origin of the cerebral blood vessels. Methods: AA atheroma was detected on baseline transesophageal echocardiogram (TEE) in 167 consecutive patients who had stroke or TIA. Of these, 125 consented to a follow-up TEE at12 months. Adequate paired AA images were obtained in 117 (78 with strokes, 39 with TIAs), which allowed detailed measurements of plaques. On admission for their index stroke or TIA, patients were assessed for stroke risk factors and stroke prevention medications (Statins, Antiplatelet therapy and oral anticoagulant). We assessed three segments of the AA adjacent to the origin of the cerebral blood vessels for plaque thickness by TEE and analyzed the effect of medication using joint modeling, with due consideration to confounding covariates. The statistical paradigm included a permutation testing procedure to determine the significance of medication effect on plaque progression in the three segments in combination. Results: Using the specified statistical paradigm, it is evident that statin therapy is effective in arresting the AA progression; however, there is no significant change induced by anticoagulant therapy. The cleaned data, after removal of influential observations, shows even more significance for the statin therapy. The constrained hypothesis tests in both cases show a smaller p-value suggesting that the statin therapy may be effective in arresting the AA progression. Conclusions: In this preliminary study of stroke/TIA patients with AA atheroma on transesophageal echocardiogram, AA atheroma progression was arrested by statin therapy, without any significant change induced by anticoagulant therapy. The statistical paradigm with due consideration of all segments implicated in stroke pathophysiology may be used to test the effect of other stroke prevention medications on AA progression.

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Effect of lipid-lowering therapy with atorvastatin on atherosclerotic aortic plaques: a 2-year follow-up by noninvasive MRI

Abstract: Twenty milligrams of atorvastatin regressed thoracic plaques. However, maintaining low LDL-cholesterol levels was needed to prevent plaque progression. In abdominal aorta, only retardation of plaque progression was found after 2 years of 20-mg treatment.

Cited by 29 publications

References 20 publications

Aortic Atherosclerosis as an Embolic Source

Aortic Atherosclerosis as an Embolic Source

Carotid Atherosclerotic Plaque Progression and Change in Plaque Composition Over Time: A 5-Year Follow-Up Study Using Serial CT Angiography

Effect of stroke prevention medication on aortic atheroma progression assessed using new statistical paradigm

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