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

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Citation: Circulation Journal. 83(7):1480-1488, 2019 06 25.PMID: 31118354Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 TopicYear: 2019ISSN:
  • 1346-9843
Name of journal: Circulation journal : official journal of the Japanese Circulation SocietyAbstract: 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, I<sup>2</sup>=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 I<sup>2</sup>=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.All authors: Beyene SS, Garcia-Garcia HM, Hideo-Kajita A, Kolm P, Kuku KO, Ozaki Y, Waksman ROriginally published: Circulation Journal. 2019 May 22Fiscal year: FY2019Digital Object Identifier: Date added to catalog: 2019-06-21
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Journal Article MedStar Authors Catalog Article 31118354 Available 31118354

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, I<sup>2</sup>=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 I<sup>2</sup>=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.

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