Predictors of carotid atherosclerotic plaque progression as measured by noninvasive magnetic resonance imaging

Abstract

The purpose of this in vivo MRI study was to quantify changes in atherosclerotic plaque morphology prospectively and to identify factors that may alter the rate of progression in plaque burden. Sixtyeight asymptomatic subjects with ≥50% stenosis, underwent serial carotid MRI examinations over an 18 month period. Clinical risk factors for atherosclerosis, and medications were documented prospectively. The wall and total vessel areas, matched across time-points, were measured from cross-sectional images. The normalized wall index (NWI = wall area / total vessel area), as a marker of disease severity, was documented at baseline and at 18 months. Multiple regression analysis was used to correlate risk factors and morphological features of the plaque with the rate of progression/ regression.On average, the wall area increased by 2.2%/year (P=0.001). Multiple regression analysis demonstrated that statin therapy (P=0.01) and a normalized wall index >0.64 (P=0.001) were associated with a significantly reduced rate of progression in mean wall area. All other documented risk factors were not significantly associated with changes in wall area. Findings from this study suggest that increased normalized wall index and the use of statin therapy are associated with reduced Address for Correspondence: Thomas S. Hatsukami, MD VA Puget Sound Health Care System Surgery and Perioperative Care (112)

Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment

“…Table 3 provides an overview of prior studies 15, 29, 30. Many factors influence the overall changes in atherosclerosis including study population, prior statin therapy, and intensity of statin therapy.…”

In Vivo Imaging of Mineral Deposition in Carotid Plaque Using 18F-Sodium Fluoride PET/CT: Correlation with Atherogenic Risk Factors

“…Tahara et al observed that the attenuation of plaque inflammation caused by statins can be monitored by 18 F-FDG PET/CT (10). Another study demonstrated that statin therapy is associated with reduced rates of plaque progression among individuals with asymptomatic carotid atherosclerosis (24). Because statins exhibit a variety of cholesterol-independent, plaque-stabilizing effects involved in endothelial function, cell proliferation, inflammatory response, and lipid oxidation, they might ultimately affect 18 F-sodium fluoride uptake (25).…”

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

“…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.…”

“…In a prospective MR imaging study, Saam et al described a yearly increase of 2.2% in wall area in Ͼ50% stenosed carotid arteries. 19 Boussel et al found an annual rate of progression of carotid vessel wall volume of 2.3% per year in arteries with Ͼ50% stenosis. 20 In these studies, however, the included arteries had more severe stenosis compared with the arteries included in our study.…”