OBJECTIVES: The study sought to test whether high-dose statin treatment would result in greater reductions in plaque inflammation than low-dose statins, using fluorodeoxyglucose-positron emission tomography/computed tomographic imaging (FDG-PET/CT). BACKGROUND: Intensification of statin therapy reduces major cardiovascular events. METHODS:Adults with risk factors or with established atherosclerosis, who were not taking high-dose statins (n = 83), were randomized to atorvastatin 10 versus 80 mg in a double-blind, multicenter trial. FDG-PET/CT imaging of the ascending thoracic aorta and carotid arteries was performed at baseline, 4, and 12 weeks after randomization and target-to-background ratio (TBR) of FDG uptake within the artery wall was assessed while blinded to time points and treatment. RESULTS:Sixty-seven subjects completed the study, providing imaging data for analysis. At 12 weeks, inflammation (TBR) in the index vessel was significantly reduced from baseline with atorvastatin 80 mg (% reduction [95% confidence interval]: 14.42% [8.7% to 19.8%]; p < 0.001), but not atorvastatin 10 mg (% reduction: 4.2% [-2.3% to 10.4%]; p > 0.1). Atorvastatin 80 mg resulted in significant additional relative reductions in TBR versus atorvastatin 10 mg (10.6% [2.2% to 18.3%]; p = 0.01) at week 12. Reductions from baseline in TBR were seen as early as 4 weeks after randomization with atorvastatin 10 mg (6.4% reduction, p < 0.05) and 80 mg (12.5% reduction, p < 0.001). Changes in TBR did not correlate with lipid profile changes. CONCLUSIONS:Statin therapy produced significant rapid dose-dependent reductions in FDG uptake that may represent changes in atherosclerotic plaque inflammation. FDG-PET imaging may be useful in detecting early treatment effects in patients at risk or with established atherosclerosis.
RCT Entities:
OBJECTIVES: The study sought to test whether high-dose statin treatment would result in greater reductions in plaque inflammation than low-dose statins, using fluorodeoxyglucose-positron emission tomography/computed tomographic imaging (FDG-PET/CT). BACKGROUND: Intensification of statin therapy reduces major cardiovascular events. METHODS: Adults with risk factors or with established atherosclerosis, who were not taking high-dose statins (n = 83), were randomized to atorvastatin 10 versus 80 mg in a double-blind, multicenter trial. FDG-PET/CT imaging of the ascending thoracic aorta and carotid arteries was performed at baseline, 4, and 12 weeks after randomization and target-to-background ratio (TBR) of FDG uptake within the artery wall was assessed while blinded to time points and treatment. RESULTS: Sixty-seven subjects completed the study, providing imaging data for analysis. At 12 weeks, inflammation (TBR) in the index vessel was significantly reduced from baseline with atorvastatin 80 mg (% reduction [95% confidence interval]: 14.42% [8.7% to 19.8%]; p < 0.001), but not atorvastatin 10 mg (% reduction: 4.2% [-2.3% to 10.4%]; p > 0.1). Atorvastatin 80 mg resulted in significant additional relative reductions in TBR versus atorvastatin 10 mg (10.6% [2.2% to 18.3%]; p = 0.01) at week 12. Reductions from baseline in TBR were seen as early as 4 weeks after randomization with atorvastatin 10 mg (6.4% reduction, p < 0.05) and 80 mg (12.5% reduction, p < 0.001). Changes in TBR did not correlate with lipid profile changes. CONCLUSIONS: Statin therapy produced significant rapid dose-dependent reductions in FDG uptake that may represent changes in atherosclerotic plaque inflammation. FDG-PET imaging may be useful in detecting early treatment effects in patients at risk or with established atherosclerosis.
Authors: Markella V Zanni; Mabel Toribio; Gregory K Robbins; Tricia H Burdo; Michael T Lu; Amorina E Ishai; Meghan N Feldpausch; Amanda Martin; Kathy Melbourne; Virginia A Triant; Sujit Suchindran; Hang Lee; Udo Hoffmann; Kenneth C Williams; Ahmed Tawakol; Steven K Grinspoon Journal: JAMA Cardiol Date: 2016-07-01 Impact factor: 14.676
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Authors: Amit K Dey; Aditya A Joshi; Abhishek Chaturvedi; Joseph B Lerman; Tsion M Aberra; Justin A Rodante; Heather L Teague; Charlotte L Harrington; Joshua P Rivers; Jonathan H Chung; Mohammad Tarek Kabbany; Balaji Natarajan; Joanna I Silverman; Qimin Ng; Gregory E Sanda; Alexander V Sorokin; Yvonne Baumer; Emily Gerson; Ronald B Prussick; Alison Ehrlich; Lawrence J Green; Benjamin N Lockshin; Mark A Ahlman; Martin P Playford; Joel M Gelfand; Nehal N Mehta Journal: JAMA Cardiol Date: 2017-09-01 Impact factor: 14.676
Authors: Sijia Yi; Xiaohan Zhang; Hussain Sangji; Yugang Liu; Sean D Allen; Baixue Xiao; Sharan Bobbala; Cameron L Braverman; Lei Cai; Peter I Hecker; Mathew DeBerge; Edward B Thorp; Ryan E Temel; Samuel I Stupp; Evan A Scott Journal: Adv Funct Mater Date: 2019-08-12 Impact factor: 18.808