A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography

Subhi J. Al'Aref, Amanda Su, Heidi Gransar, Alexander R. van Rosendael, Asim Rizvi, Daniel S. Berman, Tracy Q. Callister, Augustin DeLago, Martin Hadamitzky, Joerg Hausleiter, Mouaz H. Al-Mallah, Matthew J. Budoff, Philipp A. Kaufmann, Gilbert L. Raff, Kavitha Chinnaiyan, Filippo Cademartiri, Erica Maffei, Todd C. Villines, Yong Jin Kim, Jonathon LeipsicGudrun Feuchtner, Gianluca Pontone, Daniele Andreini, Hugo Marques, Pedro de Araújo Gonçalves, Ronen Rubinshtein, Stephan Achenbach, Hyuk Jae Chang, Benjamin J.W. Chow, Ricardo Cury, Yao Lu, Jeroen J. Bax, Erica C. Jones, Jessica M. Peña, Leslee J. Shaw, James K. Min, Fay Y. Lin

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)99-104
Number of pages6
JournalJournal of Cardiovascular Computed Tomography
Volume13
Issue number2
DOIs
Publication statusPublished - 2019 Mar 1

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Cross-Sectional Studies
Lipids
Drug Therapy
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Propensity Score
Therapeutics
Pathologic Constriction
Computed Tomography Angiography
Registries
Coronary Artery Disease
Linear Models
Coronary Vessels

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Al'Aref, Subhi J. ; Su, Amanda ; Gransar, Heidi ; van Rosendael, Alexander R. ; Rizvi, Asim ; Berman, Daniel S. ; Callister, Tracy Q. ; DeLago, Augustin ; Hadamitzky, Martin ; Hausleiter, Joerg ; Al-Mallah, Mouaz H. ; Budoff, Matthew J. ; Kaufmann, Philipp A. ; Raff, Gilbert L. ; Chinnaiyan, Kavitha ; Cademartiri, Filippo ; Maffei, Erica ; Villines, Todd C. ; Kim, Yong Jin ; Leipsic, Jonathon ; Feuchtner, Gudrun ; Pontone, Gianluca ; Andreini, Daniele ; Marques, Hugo ; de Araújo Gonçalves, Pedro ; Rubinshtein, Ronen ; Achenbach, Stephan ; Chang, Hyuk Jae ; Chow, Benjamin J.W. ; Cury, Ricardo ; Lu, Yao ; Bax, Jeroen J. ; Jones, Erica C. ; Peña, Jessica M. ; Shaw, Leslee J. ; Min, James K. ; Lin, Fay Y. / A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography. In: Journal of Cardiovascular Computed Tomography. 2019 ; Vol. 13, No. 2. pp. 99-104.
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abstract = "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.",
author = "Al'Aref, {Subhi J.} and Amanda Su and Heidi Gransar and {van Rosendael}, {Alexander R.} and Asim Rizvi and Berman, {Daniel S.} and Callister, {Tracy Q.} and Augustin DeLago and Martin Hadamitzky and Joerg Hausleiter and Al-Mallah, {Mouaz H.} and Budoff, {Matthew J.} and Kaufmann, {Philipp A.} and Raff, {Gilbert L.} and Kavitha Chinnaiyan and Filippo Cademartiri and Erica Maffei and Villines, {Todd C.} and Kim, {Yong Jin} and Jonathon Leipsic and Gudrun Feuchtner and Gianluca Pontone and Daniele Andreini and Hugo Marques and {de Ara{\'u}jo Gon{\cc}alves}, Pedro and Ronen Rubinshtein and Stephan Achenbach and Chang, {Hyuk Jae} and Chow, {Benjamin J.W.} and Ricardo Cury and Yao Lu and Bax, {Jeroen J.} and Jones, {Erica C.} and Pe{\~n}a, {Jessica M.} and Shaw, {Leslee J.} and Min, {James K.} and Lin, {Fay Y.}",
year = "2019",
month = "3",
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doi = "10.1016/j.jcct.2019.01.015",
language = "English",
volume = "13",
pages = "99--104",
journal = "Journal of Cardiovascular Computed Tomography",
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Al'Aref, SJ, Su, A, Gransar, H, van Rosendael, AR, Rizvi, A, Berman, DS, Callister, TQ, DeLago, A, Hadamitzky, M, Hausleiter, J, Al-Mallah, MH, Budoff, MJ, Kaufmann, PA, Raff, GL, Chinnaiyan, K, Cademartiri, F, Maffei, E, Villines, TC, Kim, YJ, Leipsic, J, Feuchtner, G, Pontone, G, Andreini, D, Marques, H, de Araújo Gonçalves, P, Rubinshtein, R, Achenbach, S, Chang, HJ, Chow, BJW, Cury, R, Lu, Y, Bax, JJ, Jones, EC, Peña, JM, Shaw, LJ, Min, JK & Lin, FY 2019, 'A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography', Journal of Cardiovascular Computed Tomography, vol. 13, no. 2, pp. 99-104. https://doi.org/10.1016/j.jcct.2019.01.015

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, Subhi J.; Su, Amanda; Gransar, Heidi; van Rosendael, Alexander R.; Rizvi, Asim; Berman, Daniel S.; Callister, Tracy Q.; DeLago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Al-Mallah, Mouaz H.; Budoff, Matthew J.; Kaufmann, Philipp A.; Raff, Gilbert L.; Chinnaiyan, Kavitha; Cademartiri, Filippo; Maffei, Erica; Villines, Todd C.; Kim, Yong Jin; Leipsic, Jonathon; Feuchtner, Gudrun; Pontone, Gianluca; Andreini, Daniele; Marques, Hugo; de Araújo Gonçalves, Pedro; Rubinshtein, Ronen; Achenbach, Stephan; Chang, Hyuk Jae; Chow, Benjamin J.W.; Cury, Ricardo; Lu, Yao; Bax, Jeroen J.; Jones, Erica C.; Peña, Jessica M.; Shaw, Leslee J.; Min, James K.; Lin, Fay Y.

In: Journal of Cardiovascular Computed Tomography, Vol. 13, No. 2, 01.03.2019, p. 99-104.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography

AU - Al'Aref, Subhi J.

AU - Su, Amanda

AU - Gransar, Heidi

AU - van Rosendael, Alexander R.

AU - Rizvi, Asim

AU - Berman, Daniel S.

AU - Callister, Tracy Q.

AU - DeLago, Augustin

AU - Hadamitzky, Martin

AU - Hausleiter, Joerg

AU - Al-Mallah, Mouaz H.

AU - Budoff, Matthew J.

AU - Kaufmann, Philipp A.

AU - Raff, Gilbert L.

AU - Chinnaiyan, Kavitha

AU - Cademartiri, Filippo

AU - Maffei, Erica

AU - Villines, Todd C.

AU - Kim, Yong Jin

AU - Leipsic, Jonathon

AU - Feuchtner, Gudrun

AU - Pontone, Gianluca

AU - Andreini, Daniele

AU - Marques, Hugo

AU - de Araújo Gonçalves, Pedro

AU - Rubinshtein, Ronen

AU - Achenbach, Stephan

AU - Chang, Hyuk Jae

AU - Chow, Benjamin J.W.

AU - Cury, Ricardo

AU - Lu, Yao

AU - Bax, Jeroen J.

AU - Jones, Erica C.

AU - Peña, Jessica M.

AU - Shaw, Leslee J.

AU - Min, James K.

AU - Lin, Fay Y.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - 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.

AB - 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.

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DO - 10.1016/j.jcct.2019.01.015

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JO - Journal of Cardiovascular Computed Tomography

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