Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment

Abstract

BackgroundThis study aimed to determine the relationship of statin therapy and cardiovascular risk factors to changes in atherosclerosis in the carotid artery.Methods and ResultsCarotid magnetic resonance imaging was used to evaluate 106 hyperlipidemic participants at baseline and after 12 months of 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase inhibitor (statin) treatment. Multivariable logistic regression was used to determine factors associated with progression (change in carotid wall volume >0) or regression (change ≤0) of carotid atherosclerosis. Computed tomography coronary calcium scores were obtained at baseline for all participants. The median age was 65 years (interquartile range 60–69 years), and 63% of the participants were male. Body mass index >30, elevated C‐reactive protein, and hypertension were associated with increased carotid wall volume (obesity: odds ratio for progression 4.6, 95% CI 1.8–12.4, P<0.01; C‐reactive protein: odds ratio for progression 2.56, 95% CI 1.17–5.73, P=0.02; hypertension: odds ratio 2.4, 95% CI 1.1–5.3, P<0.05). Higher statin dose was associated with regression of carotid wall volume (P<0.05). In multivariable analysis, obesity remained associated with progression (P<0.01), whereas statin use remained associated with regression (P<0.05). Change in atheroma volume in obese participants was +4.8% versus −4.2% in nonobese participants (P<0.05) despite greater low‐density lipoprotein cholesterol reduction in obese participants.ConclusionsIn a population with hyperlipidemia, obese patients showed atheroma progression despite optimized statin therapy.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01212900.

Internal tissue references for 18Fluorodeoxyglucose vascular inflammation imaging: Implications for cardiovascular risk stratification and clinical trials

“…While our dosing strategy based on LBM was originally intended to reduce radiation and normalize for the FDG volume of distribution, it was not intended for, and likely not sufficient for correction for variation in image noise related to attenuation in some patients. Because of these uncertainties and the relationship of obesity to atherosclerosis [ 27 ], it is challenging to interpret a lack of statistical significance for LBM. Techniques to harmonize image noise [ 8 ] were outside the scope of this work, but are endorsed for future consideration.…”

The Role of α1-Microglobulin (A1M) in Erythropoiesis and Erythrocyte Homeostasis—Therapeutic Opportunities in Hemolytic Conditions

“…Furthermore, the recently described A1M-KO mice gained more weight and showed fat accumulation in the liver [ 20 ], which are both atherosclerotic risk factors [ 143 , 144 , 145 ]. Although plaque formation and vascular health were not examined in the A1M-KO mice, this suggests that A1M may play a role in protection against atherosclerosis.…”

Vascular calcification in patients with large-vessel vasculitis compared to patients with hyperlipidemia

“…Clinical assessments were performed blinded to imaging data. Patients with hyperlipidemia over the age of 55 were prospectively enrolled in a parallel study as previously described (21).…”