Abstract

Background: Coronary plaque volume and its progression is an independent predictor of cardiovascular mortality. This study evaluates the overall and composition-specific (noncalcified, mixed or calcified) change in plaque volume measured by computed tomography angiography (CTA) in response to statin therapy. Methods: One hundred and seven consecutive subjects (age 67±9 years, 80.7% men) who underwent serial clinically indicated CTAs with median interval of 1.2 year, were studied. clinical and demogrpahic findings of 31 with statin therapy and 75 without statin therapy were evaluated. Total and composition-specific plaque volume of target segment with luminal stenosis0.05). At follow-up, there were -38.2% decrease in plaque volume in individuals with statin therapy as compared to those without statin therapy (p=0.0001), and remained significant even after adjustment for age, gender and conventional risk factors. Similarly, significant decrease in noncalcified and mixed plaque as well as lack of progression of calcified plaque in statin therapy group was noted (p<0.05). Risk factor adjusted median decrease in overall, mixed, calcified and noncalcified plaque volumes were 56%, 12%, 43% and 144% more in statin therapy group as compared to those without statin therapy, which was more robust in women(p<0.05). Conclusion: Statin therapy was associated with significant decrease in plaque volume, especially noncalcified plaques, prominently in women. CTA accurately measures the overall and composition-specific change in plaque volume in response to statin therapy; highlighting its important role as a non-invasive modality, to monitor response to anti-atherosclerosis therapy and its management.

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