CLINICAL RESEARCH: CARDIAC IMAGING
Effect of lipid-lowering therapy with atorvastatin on atherosclerotic aortic plaques detected by noninvasive magnetic resonance imaging
Atsushi Yonemura, MD*,
Yukihiko Momiyama, MD*,*,
Zahi A. Fayad, PhD ,
Makoto Ayaori, MD*,
Reiko Ohmori, PhD*,
Kenji Higashi, MD*,
Teruyoshi Kihara, MS ,
Shojiro Sawada, MD*,
Noriyuki Iwamoto, MD*,
Masatsune Ogura, MD*,
Hiroaki Taniguchi, MD*,
Masatoshi Kusuhara, MD*,
Masayoshi Nagata, MD,
Haruo Nakamura, MD*,
Seiichi Tamai, MD* and
Fumitaka Ohsuzu, MD, FACC*
* National Defense Medical College, Saitama, Japan
Iruma Heart Hospital, Saitama, Japan
Mount Sinai School of Medicine, New York, New York
Manuscript received August 3, 2004;
revised manuscript received October 15, 2004,
accepted November 3, 2004.
* Reprint requests and correspondence: Dr. Yukihiko Momiyama, First Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan (Email: momiyama{at}me.ndmc.ac.jp).
OBJECTIVES: We sought to elucidate the effects of 20-mg versus 5-mg atorvastatin on thoracic and abdominal aortic plaques.
BACKGROUND: Regression of thoracic aortic plaques by simvastatin was demonstrated using magnetic resonance imaging (MRI). However, the effects of different doses of statin have not been assessed.
METHODS: Using MRI, we investigated the effects of 20-mg versus 5-mg atorvastatin on thoracic and abdominal aortic plaques in 40 hypercholesterolemic patients who were randomized to receive either dose. Treatment effects were evaluated as changes in vessel wall thickness (VWT) and vessel wall area (VWA) of atherosclerotic lesions from baseline to 12 months of treatment.
RESULTS: The 20-mg dose induced a greater low-density lipoprotein (LDL) cholesterol reduction than did the 5-mg dose (–47% vs. –34%, p < 0.001). Although 20 mg and 5 mg reduced C-reactive protein (CRP) levels (–47% and –28%), the degree of CRP reduction did not differ between the two doses. The 20-mg dose reduced VWT and VWA of thoracic aortic plaques (–12% and –18%, p < 0.001), whereas 5 mg did not (+1% and +4%). Regarding abdominal aortic plaques, even 20 mg could not reduce VWT or VWA (–1% and +3%), but instead progression was observed with 5-mg treatment (+5% and +12%, p < 0.01). Notably, the degree of plaque regression in thoracic aorta correlated with LDL cholesterol (r = 0.64) and CRP (r = 0.49) reductions. Although changes in abdominal aortic plaques only weakly correlated with LDL cholesterol reduction (r = 0.34), they correlated with age (r = 0.41).
CONCLUSIONS: One-year 20-mg atorvastatin treatment induced regression of thoracic aortic plaques with marked LDL cholesterol reduction, whereas it resulted in only retardation of plaque progression in abdominal aorta. Thoracic and abdominal aortic plaques may have different susceptibilities to lipid lowering.
|
Abbreviations and Acronyms
| | hsCRP = high-sensitivity C-reactive protein | | IMT = intima-media thickness | | LA = lumen area | | LDL = low-density lipoprotein | | MRI = magnetic resonance imaging | | PDW = proton density-weighted | | T2W = T2-weighted | | TVA = total vascular area | | VWA = vessel wall area | | VWT = vessel wall thickness |
|
This article has been cited by other articles:
|
|
|
|
 
J. H.F. Rudd, F. Hyafil, and Z. A. Fayad
Inflammation Imaging in Atherosclerosis
Arterioscler Thromb Vasc Biol,
July 1, 2009;
29(7):
1009 - 1016.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Duivenvoorden, E. de Groot, B.M. Elsen, J.S. Lameris, R.J. van der Geest, E.S. Stroes, J.J.P. Kastelein, and A.J. Nederveen
In Vivo Quantification of Carotid Artery Wall Dimensions: 3.0-Tesla MRI Versus B-Mode Ultrasound Imaging
Circ Cardiovasc Imaging,
May 1, 2009;
2(3):
235 - 242.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Ishigaki, H. Katagiri, J. Gao, T. Yamada, J. Imai, K. Uno, Y. Hasegawa, K. Kaneko, T. Ogihara, H. Ishihara, et al.
Impact of Plasma Oxidized Low-Density Lipoprotein Removal on Atherosclerosis
Circulation,
July 1, 2008;
118(1):
75 - 83.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. N. Salem, P. T. O'Gara, C. Madias, and S. G. Pauker
Valvular and Structural Heart Disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
593S - 629S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A Harloff, P Dudler, A Frydrychowicz, C Strecker, A L Stroh, A Geibel, C Weiller, A Hetzel, J Hennig, and M Markl
Reliability of aortic MRI at 3 Tesla in patients with acute cryptogenic stroke
J. Neurol. Neurosurg. Psychiatry,
May 1, 2008;
79(5):
540 - 546.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Saam, T. S. Hatsukami, N. Takaya, B. Chu, H. Underhill, W. S. Kerwin, J. Cai, M. S. Ferguson, and C. Yuan
The Vulnerable, or High-Risk, Atherosclerotic Plaque: Noninvasive MR Imaging for Characterization and Assessment
Radiology,
July 1, 2007;
244(1):
64 - 77.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kinlay
Low-Density Lipoprotein-Dependent and -Independent Effects of Cholesterol-Lowering Therapies on C-Reactive Protein: A Meta-Analysis
J. Am. Coll. Cardiol.,
May 22, 2007;
49(20):
2003 - 2009.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Yanai, H. Yoshida, Y. Tomono, and N. Tada
Atherosclerosis imaging in statin intervention trials
QJM,
May 1, 2007;
100(5):
253 - 262.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Plat, I. Beugels, M. J. J. Gijbels, M. P. J. de Winther, and R. P. Mensink
Plant sterol or stanol esters retard lesion formation in LDL receptor-deficient mice independent of changes in serum plant sterols
J. Lipid Res.,
December 1, 2006;
47(12):
2762 - 2771.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Yokoyama, N. Katakami, and Y. Yamasaki
Recent Advances of Intervention to Inhibit Progression of Carotid Intima-Media Thickness in Patients With Type 2 Diabetes Mellitus
Stroke,
September 1, 2006;
37(9):
2420 - 2427.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Kronzon and P. A. Tunick
Aortic Atherosclerotic Disease and Stroke
Circulation,
July 4, 2006;
114(1):
63 - 75.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Tedgui and Z. Mallat
Cytokines in Atherosclerosis: Pathogenic and Regulatory Pathways
Physiol Rev,
April 1, 2006;
86(2):
515 - 581.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Momiyama, R. Kato, Z. A. Fayad, N. Tanaka, H. Taniguchi, R. Ohmori, T. Kihara, A. Kameyama, K. Miyazaki, K. Kimura, et al.
A Possible Association Between Coronary Plaque Instability and Complex Plaques in Abdominal Aorta
Arterioscler Thromb Vasc Biol,
April 1, 2006;
26(4):
903 - 909.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. N. DeMaria, O. Ben-Yehuda, D. Berman, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, W. Y.W. Lew, D. Sahn, and S. Tsimikas
Highlights of the Year in JACC 2005
J. Am. Coll. Cardiol.,
January 3, 2006;
47(1):
184 - 202.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Fuster, Z. A. Fayad, P. R. Moreno, M. Poon, R. Corti, and J. J. Badimon
Atherothrombosis and High-Risk Plaque: Part II: Approaches by Noninvasive Computed Tomographic/Magnetic Resonance Imaging
J. Am. Coll. Cardiol.,
October 4, 2005;
46(7):
1209 - 1218.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
