Abstract | BACKGROUND: Coronary high-intensity plaques detected by noncontrast T1-weighted imaging may represent plaque instability. High-intensity plaques can be quantitatively assessed by a plaque-to-myocardium signal-intensity ratio (PMR). OBJECTIVES: This pilot, hypothesis-generating study sought to investigate whether intensive statin therapy would lower PMR. METHODS: Prospective serial noncontrast T1-weighted magnetic resonance imaging and computed tomography angiography were performed in 48 patients with coronary artery disease at baseline and after 12 months of intensive pitavastatin treatment with a target low-density lipoprotein cholesterol level <80 mg/dl. The control group consisted of coronary artery disease patients not treated with statins that were matched by propensity scoring (n = 48). The primary endpoint was the 12-month change in PMR. Changes in computed tomography angiography parameters and high-sensitivity C-reactive protein levels were analyzed. RESULTS: In the statin group, 12 months of statin therapy significantly improved low-density lipoprotein cholesterol levels (125 to 70 mg/dl; p < 0.001), PMR (1.38 to 1.11, an 18.9% reduction; p < 0.001), low-attenuation plaque volume, and the percentage of total atheroma volume on computed tomography. In the control group, the PMR increased significantly (from 1.22 to 1.49, a 19.2% increase; p < 0.001). Changes in PMR were correlated with changes in low-density lipoprotein cholesterol (r = 0.533; p < 0.001), high-sensitivity C-reactive protein (r = 0.347; p < 0.001), percentage of atheroma volume (r = 0.477; p < 0.001), and percentage of low-attenuation plaque volume (r = 0.416; p < 0.001). CONCLUSIONS:
Statin treatment significantly reduced the PMR of high-intensity plaques. Noncontrast T1-weighted magnetic resonance imaging could become a useful technique for repeated quantitative assessment of plaque composition. (Attempts at Plaque Vulnerability Quantification with Magnetic Resonance Imaging Using Noncontrast T1-weighted Technique [AQUAMARINE]; UMIN000003567).
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Authors | Teruo Noguchi, Atsushi Tanaka, Tomohiro Kawasaki, Yoichi Goto, Yoshiaki Morita, Yasuhide Asaumi, Kazuhiro Nakao, Reiko Fujiwara, Kunihiro Nishimura, Yoshihiro Miyamoto, Masaharu Ishihara, Hisao Ogawa, Nobuhiko Koga, Jagat Narula, Satoshi Yasuda |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 66
Issue 3
Pg. 245-256
(Jul 21 2015)
ISSN: 1558-3597 [Electronic] United States |
PMID | 26184618
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Lipoproteins, LDL
- Quinolines
- C-Reactive Protein
- pitavastatin
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Topics |
- Angiography
(methods)
- C-Reactive Protein
(analysis)
- Coronary Artery Disease
(drug therapy, pathology, physiopathology)
- Dose-Response Relationship, Drug
- Drug Monitoring
(methods)
- Female
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
(administration & dosage, adverse effects)
- Lipoproteins, LDL
(blood)
- Magnetic Resonance Imaging
(methods)
- Male
- Middle Aged
- Pilot Projects
- Plaque, Atherosclerotic
(drug therapy, pathology, physiopathology)
- Prospective Studies
- Quinolines
(administration & dosage, adverse effects)
- Reproducibility of Results
- Research Design
- Tomography, X-Ray Computed
(methods)
- Treatment Outcome
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