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A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography

Authors
 Subhi J. Al’Aref  ;  Amanda Sua  ;  Heidi Gransar  ;  Alexander R. van Rosendael  ;  Asim Rizvi  ;  Daniel S. Berman  ;  Tracy Q. Callister  ;  Augustin De Lago  ;  Martin Hadamitzky  ;  Joerg Hausleiter  ;  Mouaz H. Al-Mallah  ;  Matthew J. Budoff  ;  Philipp A. Kaufmann  ;  Gilbert L. Raff  ;  Kavitha Chinnaiyan  ;  Filippo Cademartiri  ;  Erica Maffei  ;  Todd C. Villines  ;  Yong-Jin Kim  ;  Jonathon Leipsic  ;  Gudrun Feuchtner  ;  Gianluca Pontone  ;  Daniele Andreini  ;  Hugo Marques  ;  Pedrode Araújo Gonçalves  ;  Ronen Rubinshtein  ;  Stephan Achenbach  ;  Hyuk-Jae Chang  ;  Benjamin J.W. Chow  ;  Ricardo Cury  ;  Yao Lu  ;  Jeroen J. Bax  ;  Erica C. Jones  ;  Jessica M. Peña  ;  Leslee J. Shaw  ;  James K. Min  ;  Fay Y. Lin 
Citation
 JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, Vol.13(2) : 99-104, 2019 
Journal Title
 JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY 
ISSN
 1934-5925 
Issue Date
2019
MeSH
Aged ; Asia/epidemiology ; Biomarkers/blood ; Computed Tomography Angiography ; Coronary Angiography/methods ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology ; Coronary Artery Disease/pathology ; Coronary Artery Disease/prevention & control ; Coronary Stenosis/diagnostic imaging ; Coronary Stenosis/epidemiology ; Coronary Stenosis/pathology ; Coronary Stenosis/prevention & control ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/pathology ; Cross-Sectional Studies ; Drug Therapy, Combination ; Dyslipidemias/blood ; Dyslipidemias/diagnosis ; Dyslipidemias/drug therapy ; Dyslipidemias/epidemiology ; Europe/epidemiology ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Hypolipidemic Agents/therapeutic use ; Lipids/blood ; Male ; Middle Aged ; North America/epidemiology ; Plaque, Atherosclerotic ; Predictive Value of Tests ; Prevalence ; Registries ; Risk Factors
Keywords
Coronary computed tomography angiography ;  Coronary plaque composition ; Ezetimibe ; Fibrate ; Niacin ;  Non-statin therapy
Abstract
INTRODUCTION: Non-statin therapy (NST) is used as second-line treatment when statin monotherapy is inadequate or poorly tolerated. OBJECTIVE: To determine the association of NST with plaque composition, alone or in combination with statins, in patients undergoing coronary computed tomography angiography (coronary CTA). METHODS: From the multicenter CONFIRM registry, we analyzed individuals who underwent coronary CTA with known lipid-lowering therapy status and without prior coronary artery disease at baseline. We created a propensity score for being on NST, followed by stepwise multivariate linear regression, adjusting for the propensity score as well as risk factors, to determine the association between NST and the number of coronary artery segments with each plaque type (non-calcified (NCP), partially calcified (PCP) or calcified (CP)) and segment stenosis score (SSS). RESULTS: Of the 27,125 subjects in CONFIRM, 4,945 met the inclusion criteria; 371 (7.5%) took NST. At baseline, patients on NST had more prevalent risk factors and were more likely to be on concomitant cardiac medications. After multivariate and propensity score adjustment, NST was not associated with plaque composition: NCP (0.07 increase, 95% CI: -0.05, 0.20; p = 0.26), PCP (0.10 increase, 95% CI: -0.10, 0.31; p = 0.33), CP (0.18 increase, 95% CI: -0.10, 0.46; p = 0.21) or SSS (0.45 increase, 95% CI: -0.02,0.93; p = 0.06). The absence of an effect of NST on plaque type was not modified by statin use (p for interaction > 0.05 for all). CONCLUSION: In this cross-sectional study, non-statin therapy was not associated with differences in plaque composition as assessed by coronary CTA.
Full Text
https://www.sciencedirect.com/science/article/pii/S1934592518302570
DOI
10.1016/j.jcct.2019.01.015
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170418
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