Statins use and coronary artery plaque composition: Results from the International Multicenter CONFIRM Registry

Ryo Nakazato; Heidi Gransar; Daniel S. Berman; Victor Y. Cheng; Fay Y. Lin; Stephan Achenbach; Mouaz Al-Mallah; Matthew J. Budoff; Filippo Cademartiri; Tracy Q. Callister; Hyuk Jae Chang; Ricardo C. Cury; Kavitha Chinnaiyan; Benjamin J.W. Chow; Augustin Delago; Martin Hadamitzky; Joerg Hausleiter; Philipp Kaufmann; Erica Maffei; Gilbert Raff; Leslee J. Shaw; Todd C. Villines; Allison Dunning; Gudrun Feuchtner; Yong Jin Kim; Jonathon Leipsic; James K. Min

doi:10.1016/j.atherosclerosis.2012.08.002

Statins use and coronary artery plaque composition: Results from the International Multicenter CONFIRM Registry

Ryo Nakazato, Heidi Gransar, Daniel S. Berman, Victor Y. Cheng, Fay Y. Lin, Stephan Achenbach, Mouaz Al-Mallah, Matthew J. Budoff, Filippo Cademartiri, Tracy Q. Callister, Hyuk Jae Chang, Ricardo C. Cury, Kavitha Chinnaiyan, Benjamin J.W. Chow, Augustin Delago, Martin Hadamitzky, Joerg Hausleiter, Philipp Kaufmann, Erica Maffei, Gilbert RaffLeslee J. Shaw, Todd C. Villines, Allison Dunning, Gudrun Feuchtner, Yong Jin Kim, Jonathon Leipsic, James K. Min

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

65 Citations (Scopus)

Abstract

Objective: The effect of statins on coronary artery plaque features beyond stenosis severity is not known. Coronary CT angiography (CCTA) is a novel non-invasive method that permits direct visualization of coronary atherosclerotic features, including plaque composition. We evaluated the association of statin use to coronary plaque composition type in patients without known coronary artery disease (CAD) undergoing CCTA. Methods: From consecutive individuals, we identified 6673 individuals (2413 on statin therapy and 4260 not on statin therapy) with no known CAD and available statin use status. We studied the relationship between statin use and the presence and extent of specific plaque composition types, which was graded as non-calcified (NCP), mixed (MP), or calcified (CP) plaque. Results: The mean age was 59 ± 11 (55% male). Compared to the individuals not taking statins, those taking statins had higher prevalence of risk factors and obstructive CAD. In multivariable analyses, statin use was associated with increased the presence of MP [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.27-1.68), p < 0.001] and CP (OR 1.54, 95% CI 1.36-1.74, p < 0.001), but not NCP (OR 1.11, 95% CI 0.96-1.29, p = 0.1). Further, in multivariable analyses, statin use was associated with increasing numbers of coronary segments possessing MP (OR 1.52, 95% CI 1.34-1.73, p < 0.001) and CP (OR 1.52, 95% CI 1.36-1.70, p < 0.001), but not coronary segments with NCP (OR 1.09, 95% CI 0.94-1.25, p = 0.2). Conclusion: Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium. The longitudinal effect of statins on coronary plaque composition warrants further investigation.

Original language	English
Pages (from-to)	148-153
Number of pages	6
Journal	Atherosclerosis
Volume	225
Issue number	1
DOIs	https://doi.org/10.1016/j.atherosclerosis.2012.08.002
Publication status	Published - 2012 Nov

Bibliographical note

Funding Information:
Dr. Min received modest speakers' bureau and medical advisory board compensation and significant research support from GE Healthcare. Dr. Achenbach received grant support from Siemens and Bayer Schering Pharma and has served as a consultant for Servier. Dr. Al-Mallah received support from the American Heart Association , BCBS Foundation of Michigan , and Astellas. Dr. Cademartiri received grant support from GE Healthcare and has served on the Speakers' Bureau of Bracco and as a consultant for Servier; Dr. Maffei received grant support from GE Healthcare. Dr. Chinnaiyan received grant support from Bayer Pharma and Blue Cross Blue Shield Blue Care MI . Dr. Chow received research and fellowship support from GE Healthcare, research support from Pfizer and AstraZeneca, and educational support from TeraRecon. Dr. Hausleiter received a research grant from Siemens Medical Systems . Dr. Kaufmann received institutional research support from GE Healthcare and grant support from Swiss National Science Foundation . Dr. Maffei received grant support from GE Healthcare Dr. Raff received grant support from Siemens , Blue Cross Blue Shield Blue Care MI , and Bayer Pharma . All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1016/j.atherosclerosis.2012.08.002

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Nakazato, R., Gransar, H., Berman, D. S., Cheng, V. Y., Lin, F. Y., Achenbach, S., Al-Mallah, M., Budoff, M. J., Cademartiri, F., Callister, T. Q., Chang, H. J., Cury, R. C., Chinnaiyan, K., Chow, B. J. W., Delago, A., Hadamitzky, M., Hausleiter, J., Kaufmann, P., Maffei, E., ... Min, J. K. (2012). Statins use and coronary artery plaque composition: Results from the International Multicenter CONFIRM Registry. Atherosclerosis, 225(1), 148-153. https://doi.org/10.1016/j.atherosclerosis.2012.08.002

@article{00db8ac2c57a49758396a61c335a9213,

title = "Statins use and coronary artery plaque composition: Results from the International Multicenter CONFIRM Registry",

abstract = "Objective: The effect of statins on coronary artery plaque features beyond stenosis severity is not known. Coronary CT angiography (CCTA) is a novel non-invasive method that permits direct visualization of coronary atherosclerotic features, including plaque composition. We evaluated the association of statin use to coronary plaque composition type in patients without known coronary artery disease (CAD) undergoing CCTA. Methods: From consecutive individuals, we identified 6673 individuals (2413 on statin therapy and 4260 not on statin therapy) with no known CAD and available statin use status. We studied the relationship between statin use and the presence and extent of specific plaque composition types, which was graded as non-calcified (NCP), mixed (MP), or calcified (CP) plaque. Results: The mean age was 59 ± 11 (55% male). Compared to the individuals not taking statins, those taking statins had higher prevalence of risk factors and obstructive CAD. In multivariable analyses, statin use was associated with increased the presence of MP [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.27-1.68), p < 0.001] and CP (OR 1.54, 95% CI 1.36-1.74, p < 0.001), but not NCP (OR 1.11, 95% CI 0.96-1.29, p = 0.1). Further, in multivariable analyses, statin use was associated with increasing numbers of coronary segments possessing MP (OR 1.52, 95% CI 1.34-1.73, p < 0.001) and CP (OR 1.52, 95% CI 1.36-1.70, p < 0.001), but not coronary segments with NCP (OR 1.09, 95% CI 0.94-1.25, p = 0.2). Conclusion: Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium. The longitudinal effect of statins on coronary plaque composition warrants further investigation.",

author = "Ryo Nakazato and Heidi Gransar and Berman, {Daniel S.} and Cheng, {Victor Y.} and Lin, {Fay Y.} and Stephan Achenbach and Mouaz Al-Mallah and Budoff, {Matthew J.} and Filippo Cademartiri and Callister, {Tracy Q.} and Chang, {Hyuk Jae} and Cury, {Ricardo C.} and Kavitha Chinnaiyan and Chow, {Benjamin J.W.} and Augustin Delago and Martin Hadamitzky and Joerg Hausleiter and Philipp Kaufmann and Erica Maffei and Gilbert Raff and Shaw, {Leslee J.} and Villines, {Todd C.} and Allison Dunning and Gudrun Feuchtner and Kim, {Yong Jin} and Jonathon Leipsic and Min, {James K.}",

note = "Funding Information: Dr. Min received modest speakers' bureau and medical advisory board compensation and significant research support from GE Healthcare. Dr. Achenbach received grant support from Siemens and Bayer Schering Pharma and has served as a consultant for Servier. Dr. Al-Mallah received support from the American Heart Association , BCBS Foundation of Michigan , and Astellas. Dr. Cademartiri received grant support from GE Healthcare and has served on the Speakers' Bureau of Bracco and as a consultant for Servier; Dr. Maffei received grant support from GE Healthcare. Dr. Chinnaiyan received grant support from Bayer Pharma and Blue Cross Blue Shield Blue Care MI . Dr. Chow received research and fellowship support from GE Healthcare, research support from Pfizer and AstraZeneca, and educational support from TeraRecon. Dr. Hausleiter received a research grant from Siemens Medical Systems . Dr. Kaufmann received institutional research support from GE Healthcare and grant support from Swiss National Science Foundation . Dr. Maffei received grant support from GE Healthcare Dr. Raff received grant support from Siemens , Blue Cross Blue Shield Blue Care MI , and Bayer Pharma . All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. ",

year = "2012",

month = nov,

doi = "10.1016/j.atherosclerosis.2012.08.002",

language = "English",

volume = "225",

pages = "148--153",

journal = "Atherosclerosis",

issn = "0021-9150",

publisher = "Elsevier Ireland Ltd",

number = "1",

}

Nakazato, R, Gransar, H, Berman, DS, Cheng, VY, Lin, FY, Achenbach, S, Al-Mallah, M, Budoff, MJ, Cademartiri, F, Callister, TQ, Chang, HJ, Cury, RC, Chinnaiyan, K, Chow, BJW, Delago, A, Hadamitzky, M, Hausleiter, J, Kaufmann, P, Maffei, E, Raff, G, Shaw, LJ, Villines, TC, Dunning, A, Feuchtner, G, Kim, YJ, Leipsic, J & Min, JK 2012, 'Statins use and coronary artery plaque composition: Results from the International Multicenter CONFIRM Registry', Atherosclerosis, vol. 225, no. 1, pp. 148-153. https://doi.org/10.1016/j.atherosclerosis.2012.08.002

TY - JOUR

T1 - Statins use and coronary artery plaque composition

T2 - Results from the International Multicenter CONFIRM Registry

AU - Nakazato, Ryo

AU - Gransar, Heidi

AU - Berman, Daniel S.

AU - Cheng, Victor Y.

AU - Lin, Fay Y.

AU - Achenbach, Stephan

AU - Al-Mallah, Mouaz

AU - Budoff, Matthew J.

AU - Cademartiri, Filippo

AU - Callister, Tracy Q.

AU - Chang, Hyuk Jae

AU - Cury, Ricardo C.

AU - Chinnaiyan, Kavitha

AU - Chow, Benjamin J.W.

AU - Delago, Augustin

AU - Hadamitzky, Martin

AU - Hausleiter, Joerg

AU - Kaufmann, Philipp

AU - Maffei, Erica

AU - Raff, Gilbert

AU - Shaw, Leslee J.

AU - Villines, Todd C.

AU - Dunning, Allison

AU - Feuchtner, Gudrun

AU - Kim, Yong Jin

AU - Leipsic, Jonathon

AU - Min, James K.

N1 - Funding Information: Dr. Min received modest speakers' bureau and medical advisory board compensation and significant research support from GE Healthcare. Dr. Achenbach received grant support from Siemens and Bayer Schering Pharma and has served as a consultant for Servier. Dr. Al-Mallah received support from the American Heart Association , BCBS Foundation of Michigan , and Astellas. Dr. Cademartiri received grant support from GE Healthcare and has served on the Speakers' Bureau of Bracco and as a consultant for Servier; Dr. Maffei received grant support from GE Healthcare. Dr. Chinnaiyan received grant support from Bayer Pharma and Blue Cross Blue Shield Blue Care MI . Dr. Chow received research and fellowship support from GE Healthcare, research support from Pfizer and AstraZeneca, and educational support from TeraRecon. Dr. Hausleiter received a research grant from Siemens Medical Systems . Dr. Kaufmann received institutional research support from GE Healthcare and grant support from Swiss National Science Foundation . Dr. Maffei received grant support from GE Healthcare Dr. Raff received grant support from Siemens , Blue Cross Blue Shield Blue Care MI , and Bayer Pharma . All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

PY - 2012/11

Y1 - 2012/11

N2 - Objective: The effect of statins on coronary artery plaque features beyond stenosis severity is not known. Coronary CT angiography (CCTA) is a novel non-invasive method that permits direct visualization of coronary atherosclerotic features, including plaque composition. We evaluated the association of statin use to coronary plaque composition type in patients without known coronary artery disease (CAD) undergoing CCTA. Methods: From consecutive individuals, we identified 6673 individuals (2413 on statin therapy and 4260 not on statin therapy) with no known CAD and available statin use status. We studied the relationship between statin use and the presence and extent of specific plaque composition types, which was graded as non-calcified (NCP), mixed (MP), or calcified (CP) plaque. Results: The mean age was 59 ± 11 (55% male). Compared to the individuals not taking statins, those taking statins had higher prevalence of risk factors and obstructive CAD. In multivariable analyses, statin use was associated with increased the presence of MP [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.27-1.68), p < 0.001] and CP (OR 1.54, 95% CI 1.36-1.74, p < 0.001), but not NCP (OR 1.11, 95% CI 0.96-1.29, p = 0.1). Further, in multivariable analyses, statin use was associated with increasing numbers of coronary segments possessing MP (OR 1.52, 95% CI 1.34-1.73, p < 0.001) and CP (OR 1.52, 95% CI 1.36-1.70, p < 0.001), but not coronary segments with NCP (OR 1.09, 95% CI 0.94-1.25, p = 0.2). Conclusion: Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium. The longitudinal effect of statins on coronary plaque composition warrants further investigation.

AB - Objective: The effect of statins on coronary artery plaque features beyond stenosis severity is not known. Coronary CT angiography (CCTA) is a novel non-invasive method that permits direct visualization of coronary atherosclerotic features, including plaque composition. We evaluated the association of statin use to coronary plaque composition type in patients without known coronary artery disease (CAD) undergoing CCTA. Methods: From consecutive individuals, we identified 6673 individuals (2413 on statin therapy and 4260 not on statin therapy) with no known CAD and available statin use status. We studied the relationship between statin use and the presence and extent of specific plaque composition types, which was graded as non-calcified (NCP), mixed (MP), or calcified (CP) plaque. Results: The mean age was 59 ± 11 (55% male). Compared to the individuals not taking statins, those taking statins had higher prevalence of risk factors and obstructive CAD. In multivariable analyses, statin use was associated with increased the presence of MP [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.27-1.68), p < 0.001] and CP (OR 1.54, 95% CI 1.36-1.74, p < 0.001), but not NCP (OR 1.11, 95% CI 0.96-1.29, p = 0.1). Further, in multivariable analyses, statin use was associated with increasing numbers of coronary segments possessing MP (OR 1.52, 95% CI 1.34-1.73, p < 0.001) and CP (OR 1.52, 95% CI 1.36-1.70, p < 0.001), but not coronary segments with NCP (OR 1.09, 95% CI 0.94-1.25, p = 0.2). Conclusion: Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium. The longitudinal effect of statins on coronary plaque composition warrants further investigation.

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DO - 10.1016/j.atherosclerosis.2012.08.002

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SN - 0021-9150

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JO - Atherosclerosis

JF - Atherosclerosis

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ER -

Statins use and coronary artery plaque composition: Results from the International Multicenter CONFIRM Registry

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