Impact of Intensive LDL Cholesterol Lowering on Coronary Artery Atherosclerosis Progression: A Serial CT Angiography Study

Sanghoon Shin, Hyung Bok Park, Hyuk Jae Chang, Reza Arsanjani, James K. Min, Yong Jin Kim, Byoung Kwon Lee, Jung Hyun Choi, Geu Ru Hong, Namsik Chung

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Abstract

Objectives The aim of this study was to explore the relationship between temporal changes in coronary plaque volume and the intensity of lipid-lowering treatments, utilizing coronary computed tomography angiography (CTA). Background Coronary CTA has acceptable accuracy in terms of quantitative measurement of plaque volume. Although, coronary CTA is perhaps capable of identifying the differences in plaque volume progression according to the intensity of lipid lowering treatment, to date, few studies have examined this notion. Methods In this multicenter, observational study, the authors reviewed 467 patients who underwent serial coronary CTA with a scan period of more than 2 years (median 3.2 years [2.4 to 4.8]) apart, and whose laboratory data were available within 1 month of both the baseline and follow-up coronary CTA. Among them, 147 patients (comprising 336 vessels) with visible plaque were enrolled in this study. The authors performed quantitative assessment of coronary plaque in both. Patients who achieved a low-density lipoprotein cholesterol (LDL-C) with a cut off value below 70 mg/dl at follow-up were compared with those who did not. Results Patients with LDL-C below 70 mg/dl displayed a significant attenuation in plaque progression as compared with those with follow-up LDL-C levels ≥70 mg/dl (12.7 ± 38.2 mm3 vs. 44.2 ± 73.6 mm3, respectively; p = 0.014). In multivariate analysis, factors influencing plaque progression per year was follow-up LDL-C levels ≥70 mg/dl (beta 0.193; p = 0.021). Conclusions Strict LDL-C control appeared to significantly attenuate plaque volume progression based on noninvasive quantitative assessment by coronary CTA.

Original languageEnglish
Pages (from-to)437-446
Number of pages10
JournalJACC: Cardiovascular Imaging
Volume10
Issue number4
DOIs
Publication statusPublished - 2017 Apr 1

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Shin, S., Park, H. B., Chang, H. J., Arsanjani, R., Min, J. K., Kim, Y. J., Lee, B. K., Choi, J. H., Hong, G. R., & Chung, N. (2017). Impact of Intensive LDL Cholesterol Lowering on Coronary Artery Atherosclerosis Progression: A Serial CT Angiography Study. JACC: Cardiovascular Imaging, 10(4), 437-446. https://doi.org/10.1016/j.jcmg.2016.04.013