Clinical and Coronary Plaque Predictors of Atherosclerotic Nonresponse to Statin Therapy

被引：12

作者：

van Rosendael, Sophie E. ^{[1
]}

van den Hoogen, Inge J. ^{[1
]}

Lin, Fay Y. ^{[2
]}

Andreini, Daniele ^{[3
]}

Al-Mallah, Mouaz H. ^{[4
]}

Budoff, Matthew J. ^{[5
]}

Cademartiri, Filippo ^{[6
]}

Chinnaiyan, Kavitha ^{[7
]}

Choi, Jung Hyun ^{[8
]}

Conte, Edoardo ^{[3
]}

Marques, Hugo ^{[9
]}

Gonçalves, Pedro de Araujo ^{[9
]}

Gottlieb, Ilan ^{[10
]}

Hadamitzky, Martin ^{[11
]}

Leipsic, Jonathon A. ^{[12
]}

Maffei, Erica ^{[13
]}

Pontone, Gianluca ^{[3
]}

Raff, Gilbert L.

Shin, Sanghoon ^{[14
]}

Kim, Yong-Jin ^{[15
]}

Lee, Byoung Kwon ^{[16
]}

Chun, Eun Ju ^{[17
]}

Sung, Ji Min ^{[18
,19
]}

Lee, Sang-Eun ^{[14
]}

Virmani, Renu ^{[20
]}

Samady, Habib ^{[21
]}

Stone, Peter H. ^{[22
]}

Min, James K. ^{[23
]}

Narula, Jagat ^{[2
]}

Shaw, Leslee J. ^{[2
]}

Chang, Hyuk-Jae

van Rosendael, Alexander R. ^{[1
]}

Bax, Jeroen J. ^{[1
]}

机构：

[1] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands

[2] Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, Marie Josee & Henry R Kravis Ctr Cardiovasc Hlth, Mt Sinai Heart, New York, NY USA

[3] IRCCS Milan, Ctr Cardiol Monzino, Milan, Italy

[4] Houston Methodist Hosp, Houston Methodist DeBakey Heart & Vasc Ctr, Houston, TX USA

[5] Angeles Biomed Res Inst, Dept Med, Torrance, CA USA

[6] Fdn Monasterio FTGM, Dept Radiol, CNR, Pisa, Italy

[7] William Beaumont Hosp, Dept Cardiol, Royal Oak, MI USA

[8] Pusan Univ Hosp, Pusan, South Korea

[9] Hosp Luz, Unit Cardiovasc Imaging, UNICA, Lisbon, Portugal

[10] Casa Saude Sao Jose, Dept Radiol, Rio De Janeiro, Brazil

[11] German Heart Ctr Munich, Dept Radiol & Nucl Med, Munich, Germany

[12] Univ British Columbia, Dept Med & Radiol, Vancouver, BC, Canada

[13] Area Vasta 1 ASUR Marche, Dept Radiol, Urbino, Italy

[14] Ewha Womans Univ, Seoul Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea

[15] Seoul Natl Univ, Seoul Natl Univ Hosp, Cardiovasc Ctr, Dept Internal Med,Coll Med, Seoul, South Korea

[16] Yonsei Univ, Coll Med, Gangnam Severance Hosp, Seoul, South Korea

[17] Seoul Natl Univ, Bundang Hosp, Sungnam, South Korea

[18] Yonsei Univ, Hlth Syst, Severance Cardiovasc Hosp, Div Cardiol,Coll Med, Seoul, South Korea

[19] Yonsei Univ, Hlth Syst, Yonsei Cedars Sinai Integrat Cardiovasc Imaging R, Seoul, South Korea

[20] CVPath Inst, Dept Pathol, Gaithersburg, MD USA

[21] Emory Univ, Div Cardiol, Sch Med, Atlanta, GA USA

[22] Harvard Med Sch, Brigham & Womens Hosp, Cardiovasc Div, Boston, MA USA

[23] Cleerly Inc, New York, NY USA

来源：

JACC-CARDIOVASCULAR IMAGING | 2023年 / 16卷 / 04期

基金：

新加坡国家研究基金会;

关键词：

atherosclerosis; coronary; computed tomography angiography; plaque progression; statin nonresponse; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; ARTERY-DISEASE; PROGRESSION; EVENTS; BURDEN; VOLUME; WOMEN; MEN;

D O I：

10.1016/j.jcmg.2022.10.017

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Statins reduce the incidence of major cardiovascular events, but residual risk remains. The study examined the determinants of atherosclerotic statin nonresponse. OBJECTIVES This study aimed to investigate factors associated with statin nonresponse-defined atherosclerosis progression in patients treated with statins. METHODS The multicenter PARADIGM (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging) registry included patients who underwent serial coronary computed tomography angiography $2 years apart, with whole-heart coronary tree quantification of vessel, lumen, and plaque, and matching of baseline and follow-up coronary segments and lesions. Patients with statin use at baseline and follow-up coronary computed tomography angiography were included. Atherosclerotic statin nonresponse was defined as an absolute increase in percent atheroma volume (PAV) of 1.0% or more per year. Furthermore, a secondary endpoint was defined by the additional requirement of progression of low-attenuation plaque or fibro-fatty plaque. RESULTS The authors included 649 patients (age 62.0 +/- 9.0 years, 63.5% male) on statin therapy and 205 (31.5%) experienced atherosclerotic statin nonresponse. Age, diabetes, hypertension, and all atherosclerotic plaque features measured at baseline scan (high-risk plaque [HRP] features, calcified and noncalcified PAV, and lumen volume) were significantly different between patients with and without atherosclerotic statin nonresponse, whereas only diabetes, number of HRP features, and noncalcified and calcified PAV were independently associated with atherosclerotic statin nonresponse (odds ratio [OR]: 1.41 [95% CI: 0.95-2.11], OR: 1.15 [95% CI: 1.09-1.21], OR: 1.06 [95% CI: 1.02-1.10], OR: 1.07 [95% CI: 1.03-1.12], respectively). For the secondary endpoint (N =125,19.2%), only noncalcified PAV and number of HRP features were the independent determinants (OR: 1.08 [95% CI: 1.03-1.13] and OR: 1.21 [95% CI: 1.06-1.21], respectively). CONCLUSIONS In patients treated with statins, baseline plaque characterization by plaque burden and HRP is associated with atherosclerotic statin nonresponse. Patients with the highest plaque burden including HRP were at highest risk for plaque progression, despite statin therapy. These patients may need additional therapies for further risk reduction. (J Am Coll Cardiol Img 2023;16:495-504) (c) 2023 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved.

引用

页码：495 / 504

页数：10

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