Yi-Cheng Zhu1, Xiao-Zhen Jiang2, Qing-Ke Bai3, Shu-Hao Deng1, Yuan Zhang1, Zhi-Peng Zhang4, Quan Jiang5. 1. Department of Ultrasound, Pudong New Area People's Hospital affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China. 2. Department of Internal Medicine, Pudong New Area People's Hospital affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China. 3. Department of Neurology, Pudong New Area People's Hospital affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China. 4. Department of Head and Neck Surgery, Pudong New Area People's Hospital affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China. 5. Department of Ultrasound, Pudong New Area People's Hospital affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China. Electronic address: Quan_JMD@126.com.
Abstract
BACKGROUND: The present study aimed to explore the efficacy of atorvastatin on patients with carotid plaque, applying superb microvascular imaging (SMI), andcontrast-enhanced ultrasound (CEUS) for evaluating carotid intraplaque neovascularization. METHODS: A total of 82 patients (82 carotid plaques) who were randomized into treatment group and control group underwent conventional ultrasound, CEUS, and SMI examinations. Patients in treatment group received a dose of 20 mg atorvastatin per day for 6 months while those in control group received placebo instead. Lipid parameters were assessed and intraplaque neovascularization were evaluated by CEUS and SMI before and 6 months after atorvastatin treatment. RESULTS: No significant differences were found between the 2 groups at the study entry. Patients with atorvastatin treatment received marked improvement in total cholesterol, triglyceride, and LDL-cholesterol compared with those in control group (P < .001). In treatment group, SMI-detected intraplaque neovascularization reduced from 69.23% to 48.72% while CEUS-detected ones reduced from 76.92% to 69.23%. By contrast, the percentage of intraplaque neovascularization in control group did not change too much either by SMI (65.12%, 67.44%) or CEUS (74.41%, 74.41%). The consistency between CEUS and SMI was above .75 at all assessments (P < .001). CONCLUSIONS:Atorvastatin treatment works for patients with carotid plaque by reducingLDL-cholesterol and improving plaque regression. Second, the consistency between SMI and CEUS in visualizing intraplaque neovascularization is good. That indicates a high possibility to identify carotid plaque instability by a safer and cheaper ultrasonography without contrast agent.
RCT Entities:
BACKGROUND: The present study aimed to explore the efficacy of atorvastatin on patients with carotid plaque, applying superb microvascular imaging (SMI), and contrast-enhanced ultrasound (CEUS) for evaluating carotid intraplaque neovascularization. METHODS: A total of 82 patients (82 carotid plaques) who were randomized into treatment group and control group underwent conventional ultrasound, CEUS, and SMI examinations. Patients in treatment group received a dose of 20 mg atorvastatin per day for 6 months while those in control group received placebo instead. Lipid parameters were assessed and intraplaque neovascularization were evaluated by CEUS and SMI before and 6 months after atorvastatin treatment. RESULTS: No significant differences were found between the 2 groups at the study entry. Patients with atorvastatin treatment received marked improvement in total cholesterol, triglyceride, and LDL-cholesterol compared with those in control group (P < .001). In treatment group, SMI-detected intraplaque neovascularization reduced from 69.23% to 48.72% while CEUS-detected ones reduced from 76.92% to 69.23%. By contrast, the percentage of intraplaque neovascularization in control group did not change too much either by SMI (65.12%, 67.44%) or CEUS (74.41%, 74.41%). The consistency between CEUS and SMI was above .75 at all assessments (P < .001). CONCLUSIONS:Atorvastatin treatment works for patients with carotid plaque by reducing LDL-cholesterol and improving plaque regression. Second, the consistency between SMI and CEUS in visualizing intraplaque neovascularization is good. That indicates a high possibility to identify carotid plaque instability by a safer and cheaper ultrasonography without contrast agent.
Authors: Arcangelo Iannuzzi; Paolo Rubba; Marco Gentile; Vania Mallardo; Ilenia Calcaterra; Alessandro Bresciani; Giuseppe Covetti; Gianluigi Cuomo; Pasquale Merone; Anna Di Lorenzo; Roberta Alfieri; Emilio Aliberti; Francesco Giallauria; Matteo Nicola Dario Di Minno; Gabriella Iannuzzo Journal: Biomedicines Date: 2021-05-06