Effect of Statin Therapy on Fibrous Cap Thickness in Coronary Plaque on Optical Coherence Tomography - Review and Meta-Analysis. - 2019

BACKGROUND: Statin therapy has been shown to result in coronary plaque regression, but the relationship between statin use and stabilization of coronary plaque has not been elucidated. We conducted a systematic review and meta-analysis to evaluate the effect of statin therapy on fibrous cap thickness (FCT) on optical coherence tomography (OCT).Methods and Results:Nine OCT studies (6 randomized controlled trials and 3 observational studies) were enrolled with a total of 341 patients (390 lesions). Arms of the studies were grouped according to statin type and/or dose. Random effects meta-analysis was used to estimate a pooled mean change in FCT from baseline to follow-up. The overall effect mean FCT change was 67.7 micro m (95% CI: 51.4-84.1, I2=95.0%, P<0.001). All statin groups had an increase in FCT, but the magnitude of the increase differed according to the statin. Two homogeneous subgroups with I2=0 were identified: mean FCT change was 27.8 micro m (for subgroup atorvastatin 5 mg and rosuvastatin), and 61.9 micro m (for subgroup atorvastatin 20 mg, fluvastatin 30 mg, and pitavastatin 4 mg). On meta-regression modeling, statin therapy alone explained most of the change in FCT. CONCLUSIONS: Statin therapy induced a significant increase in FCT as assessed on OCT, independent of coronary risk factors and other medications.


English

1346-9843


*Coronary Artery Disease
*Hydroxymethylglutaryl-CoA Reductase Inhibitors/tu [Therapeutic Use]
*Plaque, Atherosclerotic
*Tomography, Optical Coherence
Coronary Artery Disease/dg [Diagnostic Imaging]
Coronary Artery Disease/dt [Drug Therapy]
Female
Humans
Male
Observational Studies as Topic
Plaque, Atherosclerotic/dg [Diagnostic Imaging]
Plaque, Atherosclerotic/dt [Drug Therapy]
Randomized Controlled Trials as Topic


MedStar Heart & Vascular Institute


Journal Article