Abstract | OBJECTIVES: BACKGROUND: METHODS: Forty-seven patients with carotid stenosis >40% on duplex ultrasonography and who demonstrated intraplaque accumulation of USPIO on MRI at baseline were randomly assigned in a balanced, double-blind manner to either 10 or 80 mg atorvastatin daily for 12 weeks. Baseline statin therapy was equivalent to 10 mg of atorvastatin or less. The primary end point was change from baseline in signal intensity (DeltaSI) on USPIO-enhanced MRI in carotid plaque at 6 and 12 weeks. RESULTS: Twenty patients completed 12 weeks of treatment in each group. A significant reduction from baseline in USPIO-defined inflammation was observed in the 80-mg group at both 6 weeks (DeltaSI 0.13; p = 0.0003) and at 12 weeks (DeltaSI 0.20; p < 0.0001). No difference was observed with the low-dose regimen. The 80-mg atorvastatin dose significantly reduced total cholesterol by 15% (p = 0.0003) and low-density lipoprotein cholesterol by 29% (p = 0.0001) at 12 weeks. CONCLUSIONS: Aggressive lipid-lowering therapy over a 3-month period is associated with significant reduction in USPIO-defined inflammation. USPIO-enhanced MRI methodology may be a useful imaging biomarker for the screening and assessment of therapeutic response to "anti-inflammatory" interventions in patients with atherosclerotic lesions. (Effects of Atorvastatin on Macrophage Activity and Plaque Inflammation Using Magnetic Resonance Imaging [ ATHEROMA]; NCT00368589).
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Authors | Tjun Y Tang, Simon P S Howarth, Sam R Miller, Martin J Graves, Andrew J Patterson, Jean-Marie U-King-Im, Zhi Y Li, Stewart R Walsh, Andrew P Brown, Peter J Kirkpatrick, Elizabeth A Warburton, Paul D Hayes, Kevin Varty, Jonathan R Boyle, Michael E Gaunt, Andrew Zalewski, Jonathan H Gillard |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 53
Issue 22
Pg. 2039-50
(Jun 02 2009)
ISSN: 1558-3597 [Electronic] United States |
PMID | 19477353
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anticholesteremic Agents
- Biomarkers
- Contrast Media
- Dextrans
- Heptanoic Acids
- Magnetite Nanoparticles
- Oxides
- Pyrroles
- ferumoxtran-10
- Atorvastatin
- Iron
- Ferrosoferric Oxide
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Topics |
- Aged
- Anticholesteremic Agents
(administration & dosage, therapeutic use)
- Atorvastatin
- Biomarkers
- Carotid Arteries
(drug effects, pathology)
- Carotid Stenosis
(diagnosis, drug therapy, pathology)
- Contrast Media
- Dextrans
- Double-Blind Method
- Female
- Ferrosoferric Oxide
- Heptanoic Acids
(administration & dosage, therapeutic use)
- Humans
- Inflammation
(diagnosis, drug therapy, pathology)
- Iron
- Macrophages
(drug effects)
- Magnetic Resonance Imaging
(instrumentation, methods)
- Magnetite Nanoparticles
- Male
- Middle Aged
- Nanoparticles
- Oxides
- Pyrroles
(administration & dosage, therapeutic use)
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