The effects of statin therapy on carotid plaque composition and volume: A systematic review and meta-analysis

Waleed Brinjikji, Vance T Lehman, David F Kallmes, Alejandro Rabinstein, Giuseppe Lanzino, Mohammad H Murad, Sharon Mulvagh, James Klaas, Jonathan Graff-Radford, Kevin J. DeMarco, John Huston

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4 Citations (Scopus)

Abstract

Background and purpose: Prior studies have demonstrated that statin use stabilizes and diminishes atherosclerotic lesions. The main objective of this systematic review and meta-analysis was to study the effects of statin therapy on carotid plaque composition as seen on serial high-resolution carotid plaque MRI. We hypothesized that statin therapy would result in significant improvements in lipid-rich-necrotic-core (LRNC) volumes, wall volumes and lumen volumes. Materials and methods: Prospective studies using serial high-resolution carotid plaque MRI (1.5 or 3. T only) in patients on statin therapy to document changes in carotid plaque composition were included. All studies had a minimum of 10 patients and minimum follow-up duration of 3 months. Outcomes included change in LRNC volume, wall volume, and lumen volume at: (1) 1-6 months; (2) 7-12 months; (3) >. 12 months following initiation of statin therapy; and (4) at last follow-up. Meta-analysis was performed using the random effects model. Results were reported as weighted mean differences (WMD) and 95% confidence interval (CI). Result: Seven studies including 361 patients were included. There was no significant change in carotid wall volume or lumen volume at any time points. While there was no significant difference in LRNC at 1-6 months and at 7-12 months following initiation of statin therapy; at >12 months, there was significant decrease in LRNC volume (WMD=-9.9mm3, 95% CI=-8.9, -2.3). Conclusions: Our study suggests statin therapy is associated with significant reductions in LRNC at 1-year of statin therapy on serial carotid MRI. However, no significant reduction in carotid wall volume was seen.

Original languageEnglish (US)
JournalJournal of Neuroradiology
DOIs
StateAccepted/In press - 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Meta-Analysis
Lipids
Therapeutics
Confidence Intervals
Prospective Studies

Keywords

  • Carotid stenosis
  • MRI
  • Plaque
  • Statin

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

@article{5f68db8cc0c24e8495bd0c4fc0ab46fc,
title = "The effects of statin therapy on carotid plaque composition and volume: A systematic review and meta-analysis",
abstract = "Background and purpose: Prior studies have demonstrated that statin use stabilizes and diminishes atherosclerotic lesions. The main objective of this systematic review and meta-analysis was to study the effects of statin therapy on carotid plaque composition as seen on serial high-resolution carotid plaque MRI. We hypothesized that statin therapy would result in significant improvements in lipid-rich-necrotic-core (LRNC) volumes, wall volumes and lumen volumes. Materials and methods: Prospective studies using serial high-resolution carotid plaque MRI (1.5 or 3. T only) in patients on statin therapy to document changes in carotid plaque composition were included. All studies had a minimum of 10 patients and minimum follow-up duration of 3 months. Outcomes included change in LRNC volume, wall volume, and lumen volume at: (1) 1-6 months; (2) 7-12 months; (3) >. 12 months following initiation of statin therapy; and (4) at last follow-up. Meta-analysis was performed using the random effects model. Results were reported as weighted mean differences (WMD) and 95{\%} confidence interval (CI). Result: Seven studies including 361 patients were included. There was no significant change in carotid wall volume or lumen volume at any time points. While there was no significant difference in LRNC at 1-6 months and at 7-12 months following initiation of statin therapy; at >12 months, there was significant decrease in LRNC volume (WMD=-9.9mm3, 95{\%} CI=-8.9, -2.3). Conclusions: Our study suggests statin therapy is associated with significant reductions in LRNC at 1-year of statin therapy on serial carotid MRI. However, no significant reduction in carotid wall volume was seen.",
keywords = "Carotid stenosis, MRI, Plaque, Statin",
author = "Waleed Brinjikji and Lehman, {Vance T} and Kallmes, {David F} and Alejandro Rabinstein and Giuseppe Lanzino and Murad, {Mohammad H} and Sharon Mulvagh and James Klaas and Jonathan Graff-Radford and DeMarco, {Kevin J.} and John Huston",
year = "2017",
doi = "10.1016/j.neurad.2016.12.004",
language = "English (US)",
journal = "Journal of Neuroradiology",
issn = "0150-9861",
publisher = "Elsevier Masson",

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TY - JOUR

T1 - The effects of statin therapy on carotid plaque composition and volume

T2 - A systematic review and meta-analysis

AU - Brinjikji, Waleed

AU - Lehman, Vance T

AU - Kallmes, David F

AU - Rabinstein, Alejandro

AU - Lanzino, Giuseppe

AU - Murad, Mohammad H

AU - Mulvagh, Sharon

AU - Klaas, James

AU - Graff-Radford, Jonathan

AU - DeMarco, Kevin J.

AU - Huston, John

PY - 2017

Y1 - 2017

N2 - Background and purpose: Prior studies have demonstrated that statin use stabilizes and diminishes atherosclerotic lesions. The main objective of this systematic review and meta-analysis was to study the effects of statin therapy on carotid plaque composition as seen on serial high-resolution carotid plaque MRI. We hypothesized that statin therapy would result in significant improvements in lipid-rich-necrotic-core (LRNC) volumes, wall volumes and lumen volumes. Materials and methods: Prospective studies using serial high-resolution carotid plaque MRI (1.5 or 3. T only) in patients on statin therapy to document changes in carotid plaque composition were included. All studies had a minimum of 10 patients and minimum follow-up duration of 3 months. Outcomes included change in LRNC volume, wall volume, and lumen volume at: (1) 1-6 months; (2) 7-12 months; (3) >. 12 months following initiation of statin therapy; and (4) at last follow-up. Meta-analysis was performed using the random effects model. Results were reported as weighted mean differences (WMD) and 95% confidence interval (CI). Result: Seven studies including 361 patients were included. There was no significant change in carotid wall volume or lumen volume at any time points. While there was no significant difference in LRNC at 1-6 months and at 7-12 months following initiation of statin therapy; at >12 months, there was significant decrease in LRNC volume (WMD=-9.9mm3, 95% CI=-8.9, -2.3). Conclusions: Our study suggests statin therapy is associated with significant reductions in LRNC at 1-year of statin therapy on serial carotid MRI. However, no significant reduction in carotid wall volume was seen.

AB - Background and purpose: Prior studies have demonstrated that statin use stabilizes and diminishes atherosclerotic lesions. The main objective of this systematic review and meta-analysis was to study the effects of statin therapy on carotid plaque composition as seen on serial high-resolution carotid plaque MRI. We hypothesized that statin therapy would result in significant improvements in lipid-rich-necrotic-core (LRNC) volumes, wall volumes and lumen volumes. Materials and methods: Prospective studies using serial high-resolution carotid plaque MRI (1.5 or 3. T only) in patients on statin therapy to document changes in carotid plaque composition were included. All studies had a minimum of 10 patients and minimum follow-up duration of 3 months. Outcomes included change in LRNC volume, wall volume, and lumen volume at: (1) 1-6 months; (2) 7-12 months; (3) >. 12 months following initiation of statin therapy; and (4) at last follow-up. Meta-analysis was performed using the random effects model. Results were reported as weighted mean differences (WMD) and 95% confidence interval (CI). Result: Seven studies including 361 patients were included. There was no significant change in carotid wall volume or lumen volume at any time points. While there was no significant difference in LRNC at 1-6 months and at 7-12 months following initiation of statin therapy; at >12 months, there was significant decrease in LRNC volume (WMD=-9.9mm3, 95% CI=-8.9, -2.3). Conclusions: Our study suggests statin therapy is associated with significant reductions in LRNC at 1-year of statin therapy on serial carotid MRI. However, no significant reduction in carotid wall volume was seen.

KW - Carotid stenosis

KW - MRI

KW - Plaque

KW - Statin

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U2 - 10.1016/j.neurad.2016.12.004

DO - 10.1016/j.neurad.2016.12.004

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