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Intensification of Statin Therapy Results in a Rapid Reduction in Atherosclerotic Inflammation
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 reduce...
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Published in: | Journal of the American College of Cardiology 2013-09, Vol.62 (10), p.909-917 |
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creator | Tawakol, Ahmed, MD Fayad, Zahi A., PhD Mogg, Robin, PhD Alon, Achilles, PharmD Klimas, Michael T., PhD Dansky, Hayes, MD Subramanian, Sharath S., MD Abdelbaky, Amr, MD Rudd, James H.F., MD, PhD Farkouh, Michael E., MD, MSc Nunes, Irene O., PhD Beals, Chan R., MD Shankar, Sudha S., MD |
description | 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. (Evaluate the Utility of 18FDG-PET as a Tool to Quantify Atherosclerotic Plaque; NCT00703261 ) |
doi_str_mv | 10.1016/j.jacc.2013.04.066 |
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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. (Evaluate the Utility of 18FDG-PET as a Tool to Quantify Atherosclerotic Plaque; NCT00703261 )</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2013.04.066</identifier><language>eng</language><publisher>New York: Elsevier Inc</publisher><subject>atherosclerosis ; atorvastatin ; Body mass index ; Calcification ; Cardiology ; Cardiovascular ; Cardiovascular disease ; Cholesterol ; Confidence intervals ; Diabetes ; Drug therapy ; Family medical history ; FDG ; Gene expression ; inflammation ; Internal Medicine ; Lipoproteins ; plaque ; Statins</subject><ispartof>Journal of the American College of Cardiology, 2013-09, Vol.62 (10), p.909-917</ispartof><rights>American College of Cardiology Foundation</rights><rights>2013 American College of Cardiology Foundation</rights><rights>Copyright Elsevier Limited Sep 3, 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2948-d3937d8ee8319eff18dd78e6fcf205083b839dbbced2f976ccc93adc4cc4b9643</citedby><cites>FETCH-LOGICAL-c2948-d3937d8ee8319eff18dd78e6fcf205083b839dbbced2f976ccc93adc4cc4b9643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Tawakol, Ahmed, MD</creatorcontrib><creatorcontrib>Fayad, Zahi A., PhD</creatorcontrib><creatorcontrib>Mogg, Robin, PhD</creatorcontrib><creatorcontrib>Alon, Achilles, PharmD</creatorcontrib><creatorcontrib>Klimas, Michael T., PhD</creatorcontrib><creatorcontrib>Dansky, Hayes, MD</creatorcontrib><creatorcontrib>Subramanian, Sharath S., MD</creatorcontrib><creatorcontrib>Abdelbaky, Amr, MD</creatorcontrib><creatorcontrib>Rudd, James H.F., MD, PhD</creatorcontrib><creatorcontrib>Farkouh, Michael E., MD, MSc</creatorcontrib><creatorcontrib>Nunes, Irene O., PhD</creatorcontrib><creatorcontrib>Beals, Chan R., MD</creatorcontrib><creatorcontrib>Shankar, Sudha S., MD</creatorcontrib><title>Intensification of Statin Therapy Results in a Rapid Reduction in Atherosclerotic Inflammation</title><title>Journal of the American College of Cardiology</title><description>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. (Evaluate the Utility of 18FDG-PET as a Tool to Quantify Atherosclerotic Plaque; NCT00703261 )</description><subject>atherosclerosis</subject><subject>atorvastatin</subject><subject>Body mass index</subject><subject>Calcification</subject><subject>Cardiology</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cholesterol</subject><subject>Confidence intervals</subject><subject>Diabetes</subject><subject>Drug therapy</subject><subject>Family medical history</subject><subject>FDG</subject><subject>Gene expression</subject><subject>inflammation</subject><subject>Internal Medicine</subject><subject>Lipoproteins</subject><subject>plaque</subject><subject>Statins</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNp9kV9r2zAUxcVYYVm2L7AnQ5_tXkn-I0EplLCtgcAg7V4nlKsrJs-xM8sp5NtXbgqFPvRFEodzrg6_y9g3DgUHXl-1RWsRCwFcFlAWUNcf2IJXlcplpZuPbAGNrHIOuvnEPsfYAkCtuF6wP-t-oj4GH9BOYeizwWf3U3r22cNfGu3hlG0pHrspZkmy2dYegkuSO-KzPYm3UzIOEbt0TgGzde87u98_j_vCLrztIn19uZfs94_vD6u7fPPr53p1u8lR6FLlTmrZOEWkJNfkPVfONYpqj15ABUrulNRut0NywuumRkQtrcMSsdzpupRLdnmeexiH_0eKk2mH49inLw2vy0poDUollzi7MPWNI3lzGMPejifDwcwcTWtmjmbmaKA0iWMKXZ9DlPo_BhpNxEB9qhJGwsm4Ibwfv3kTxy70iXb3j04UX2uaKAyY-3lR8564BAFKCPkEE-uSDw</recordid><startdate>20130903</startdate><enddate>20130903</enddate><creator>Tawakol, Ahmed, MD</creator><creator>Fayad, Zahi A., PhD</creator><creator>Mogg, Robin, PhD</creator><creator>Alon, Achilles, PharmD</creator><creator>Klimas, Michael T., PhD</creator><creator>Dansky, Hayes, MD</creator><creator>Subramanian, Sharath S., MD</creator><creator>Abdelbaky, Amr, MD</creator><creator>Rudd, James H.F., MD, PhD</creator><creator>Farkouh, Michael E., MD, MSc</creator><creator>Nunes, Irene O., PhD</creator><creator>Beals, Chan R., MD</creator><creator>Shankar, Sudha S., MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20130903</creationdate><title>Intensification of Statin Therapy Results in a Rapid Reduction in Atherosclerotic Inflammation</title><author>Tawakol, Ahmed, MD ; Fayad, Zahi A., PhD ; Mogg, Robin, PhD ; Alon, Achilles, PharmD ; Klimas, Michael T., PhD ; Dansky, Hayes, MD ; Subramanian, Sharath S., MD ; Abdelbaky, Amr, MD ; Rudd, James H.F., MD, PhD ; Farkouh, Michael E., MD, MSc ; Nunes, Irene O., PhD ; Beals, Chan R., MD ; Shankar, Sudha S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2948-d3937d8ee8319eff18dd78e6fcf205083b839dbbced2f976ccc93adc4cc4b9643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>atherosclerosis</topic><topic>atorvastatin</topic><topic>Body mass index</topic><topic>Calcification</topic><topic>Cardiology</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cholesterol</topic><topic>Confidence intervals</topic><topic>Diabetes</topic><topic>Drug therapy</topic><topic>Family medical history</topic><topic>FDG</topic><topic>Gene expression</topic><topic>inflammation</topic><topic>Internal Medicine</topic><topic>Lipoproteins</topic><topic>plaque</topic><topic>Statins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tawakol, Ahmed, MD</creatorcontrib><creatorcontrib>Fayad, Zahi A., PhD</creatorcontrib><creatorcontrib>Mogg, Robin, PhD</creatorcontrib><creatorcontrib>Alon, Achilles, PharmD</creatorcontrib><creatorcontrib>Klimas, Michael T., PhD</creatorcontrib><creatorcontrib>Dansky, Hayes, MD</creatorcontrib><creatorcontrib>Subramanian, Sharath S., MD</creatorcontrib><creatorcontrib>Abdelbaky, Amr, MD</creatorcontrib><creatorcontrib>Rudd, James H.F., MD, PhD</creatorcontrib><creatorcontrib>Farkouh, Michael E., MD, MSc</creatorcontrib><creatorcontrib>Nunes, Irene O., PhD</creatorcontrib><creatorcontrib>Beals, Chan R., MD</creatorcontrib><creatorcontrib>Shankar, Sudha S., MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tawakol, Ahmed, MD</au><au>Fayad, Zahi A., PhD</au><au>Mogg, Robin, PhD</au><au>Alon, Achilles, PharmD</au><au>Klimas, Michael T., PhD</au><au>Dansky, Hayes, MD</au><au>Subramanian, Sharath S., MD</au><au>Abdelbaky, Amr, MD</au><au>Rudd, James H.F., MD, PhD</au><au>Farkouh, Michael E., MD, MSc</au><au>Nunes, Irene O., PhD</au><au>Beals, Chan R., MD</au><au>Shankar, Sudha S., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intensification of Statin Therapy Results in a Rapid Reduction in Atherosclerotic Inflammation</atitle><jtitle>Journal of the American College of Cardiology</jtitle><date>2013-09-03</date><risdate>2013</risdate><volume>62</volume><issue>10</issue><spage>909</spage><epage>917</epage><pages>909-917</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><abstract>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. (Evaluate the Utility of 18FDG-PET as a Tool to Quantify Atherosclerotic Plaque; NCT00703261 )</abstract><cop>New York</cop><pub>Elsevier Inc</pub><doi>10.1016/j.jacc.2013.04.066</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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subjects | atherosclerosis atorvastatin Body mass index Calcification Cardiology Cardiovascular Cardiovascular disease Cholesterol Confidence intervals Diabetes Drug therapy Family medical history FDG Gene expression inflammation Internal Medicine Lipoproteins plaque Statins |
title | Intensification of Statin Therapy Results in a Rapid Reduction in Atherosclerotic Inflammation |
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