The effect of statin therapy on plaque regression following acute coronary syndrome

作者：Xuejiao Tang, Yuan Yang, Suxin Luo, Yue Zhao, Chunyan Lu, Yongbai Luo, Fan Zhang, Hua Xiao · 发表于：Coronary Artery Disease · 年份：2016 · DOI：10.1097/mca.0000000000000403 · 被引用次数：19 · 研究领域：Lipoproteins and Cardiovascular Health、Cardiac Imaging and Diagnostics、Cancer, Lipids, and Metabolism

OBJECTIVE: To investigate the effect of statins on plaque regression after acute coronary syndrome (ACS). METHODS: We carried out a meta-analysis to assess the change in plaque and plaque components in patients with ACS under statin therapy. This meta-analysis combined data of 1623 participants from eight randomized-controlled trials and seven observational studies. RESULTS: The benefits of high-intensity statin therapy on plaque regression occurred after 6 months [standardized mean difference (SMD): -0.27; 95% confidence interval (CI): -0.43 to -0.12; P=0.0006] and were sustained over 12 months (SMD: -0.14; 95% CI: -0.25 to -0.03; P=0.01). No significant decrease was observed in the plaque volume and percent plaque volume under low-dose statin treatment. After 6 months of intensive statin treatment, the plaque volume reduced significantly in patients whose follow-up LDL cholesterol levels did (SMD: -0.16; 95% CI: -0.29 to -0.03; P=0.02) or did not (SMD: -0.21; 95% CI: -0.32 to -0.09; P=0.0007) decrease to 70 mg/dl or less. There was no significant change in plaque composition volumes, but an increase was found in the percent dense calcium volume of 1.31% (95% CI: 0.55-2.07%; P=0.0007). CONCLUSION: Intensive statin therapy duration over 6 months may be as important as achieved LDL-C of less than or equal to 70 mg/dl in plaque regression following ACS. Intensive statin treatment may lead to an earlier regression compared with low-dose statin therapy.