which statins are most associated with soft plaque regression quizlet sustivawhich statins are most associated with soft plaque regression quizlet sustiva

Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018. Clipboard, Search History, and several other advanced features are temporarily unavailable. Statins use and coronary artery plaque composition: results from the International Multicenter CONFIRM Registry. Clinical classification of plaque morphology in coronary disease. Within this observational registry, in which patients underwent serial coronary CTA at least 2 years apart (median 3.2 years), 548 were treated with statins and 309 were untreated. Mayo Clinic, Rochester, Minn. March 18, 2019. health information, we will treat all of that information as protected health In the statin-treated group, LDL-cholesterol levels were slightly lower than in the untreated group at baseline (107 vs 113 mg/dL; P = 0.03) but markedly lower in follow-up (88 vs 110 mg/dL; P < 0.001). Atorvastatin and simvastatin are the most effective at reducing LDL cholesterol levels. The study excluded patients with noninterpretable CCTA findings, patients without lesions at baseline as well as at follow-up, patients initiating or stopping statin after baseline CCTA, patients with unknown information regarding statin use, and those with tandem lesions at baseline that were confluent at follow-up. Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease. Objectives: A fib reduction 5. reduced inflammation (decreased CRP) 6. reduce free radicals statin toxicity Stay up-to-date with breaking news, conference slides, and topical videos covering the spectrum of CVD. 2023 American College of Cardiology Foundation. Unable to load your collection due to an error, Unable to load your delegates due to an error. A key mechanism underlying this phenomenon is that statins increase plaque density thereby paradoxically raising the Agatston CAC scoreas density is upweighted. . Arnett DK, Blumenthal RS, Albert MA, et al. Detrano R, Guerci AD, Carr JJ, et al. Cerebrovasc Dis. MeSH Discuss these steps with your doctor before trying them: Although side effects believed to be caused by statins can be annoying, consider the benefits of taking a statin before you decide to stop taking your medication. information is beneficial, we may combine your email and website usage information with Atorvastatin (Lipitor) Rosuvastatin (Crestor) Because they remain active for a longer period of time Statin lipophilicity may be related to SE and myopathy. 2022 Oct 26;23(21):12906. doi: 10.3390/ijms232112906. Statin therapy is associated with atherosclerotic plaque transformation to higher calcium density, which is associated with slower plaque progression. Epub 2018 Aug 30. Hypothyroidism: Should I take iodine supplements? If you have read about the potential side effects of statins, you may be more likely to blame your symptoms on the medication, whether or not they're truly caused by the drug. To better understand the changes associated with statin therapy on certain plaque subtypes, the authors enrolled 2,252 patients from the CCTA PARADIGM study. You may feel this pain as a soreness, tiredness or weakness in your muscles. enriches our understanding about the role of CAC scores in statin users, a critical clinical and research question for preventive cardiology.18,19 Studies in cohorts with high rates of baseline statin use, e.g., populations with diabetes,20familial hypercholesterolemia,21,22 or patients with chest pain undergoing coronary computed tomography angiography (CCTA)23 suggest that CAC also stratifies risk of future events in these settings. Otsuka F, Joner M, Prati F, Virmani R, Narula J. 2021;Epub ahead of print. Sandesara PB, Mehta A, O'Neal WT, et al. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. PMC 1. For patients undergoing CAC screening, the new data can help refine how best to assess patient risk. The aim of the present study was to compare the effects of statin /ezetimibe combination therapy and statin monotherapy on carotid atherosclerotic plaque inflammation using 18 F-fluorodeoxyglucose (18 FDG . The secondary pur-pose of the present study was to assess the impact of clinical findings, laboratory findings, and intravascular ultrasound Higher calcium density is associated with slowed plaque progression. Coronary atherosclerotic precursors of acute coronary syndromes. 2022 Oct 18;54(5):991-999. doi: 10.19723/j.issn.1671-167X.2022.05.028. Models adjusted for atheroma volume showed that changes in calcium indices were significantly greater in both . Coronary calcium as a predictor of coronary events in four racial or ethnic groups. There is calcified and noncalcified plaque, and it looks like the calcified part of the plaque does have less prognostic value than the noncalcified plaque., For example, studies have shown that low-attenuation plaque on CTA strongly predicts future events, such as MI. The .gov means its official. On the flip side, van Rosendael previously showed that the presence of very dense coronary plaque. Combining cholesterol-lowering strategies with imaging data: a visible benefit? Introduction: Statins or 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors are one of the foremost commonly endorsed medications in cardiac patients. Talk to your doctor to see if a change of dosage or even a different type of medication might be helpful. In patients not on a statin, low-attenuation and fibro-fatty plaque volumes increased over time. Unauthorized use of these marks is strictly prohibited. Statin users had higher baseline CAC scores (281 vs. 107) with larger mean CAC area and density. Indeed, Criqui et al 18 have shown that, in humans, calcium density is inversely associated with event risk, suggesting that calcifications may contribute to lesion . Most people don't have side effects from statins, but you shouldn't take them if you're pregnant, nursing or . Int J Mol Sci. If the plaque is mainly composed of very dense calcium, then itll progress less in total volume, said van Rosendael. Please enable it to take advantage of the complete set of features! Use of coronary artery calcium testing to guide aspirin utilization for primary prevention: estimates from the multi-ethnic study of atherosclerosis. Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. There is calcified and noncalcified plaque, and it looks like the calcified part of the plaque does have less prognostic value than the noncalcified plaque.. Al'Aref SJ, Su A, Gransar H, van Rosendael AR, Rizvi A, Berman DS, Callister TQ, DeLago A, Hadamitzky M, Hausleiter J, Al-Mallah MH, Budoff MJ, Kaufmann PA, Raff GL, Chinnaiyan K, Cademartiri F, Maffei E, Villines TC, Kim YJ, Leipsic J, Feuchtner G, Pontone G, Andreini D, Marques H, de Arajo Gonalves P, Rubinshtein R, Achenbach S, Chang HJ, Chow BJW, Cury R, Lu Y, Bax JJ, Jones EC, Pea JM, Shaw LJ, Min JK, Lin FY. privacy practices. 2023 Mar 17;23(1):81. doi: 10.1186/s12906-023-03899-9. Very rarely, statins can cause life-threatening muscle damage called rhabdomyolysis (rab-doe-my-OL-ih-sis). We used logistic regression models to study the association of statin use with the presence of plaque components. The Agatston CAC score stratifies CHD/CVD event risk in statin users. 17-19 Moreover, although statin-induced lipid lowering and clinical benefits may . https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm293330.htm. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). coronary artery calcium (CAC), Agatston units, and presence of obstructive coronary artery disease. Whats the Difference Between Good and Bad Cholesterol? The associations between CAC burden and outcomes are summarized in Table 1. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. van Rosendael AR, Narula J, Lin FY, et al. Controlling cholesterol with statins. Accessibility Greenland P, Blaha MJ, Budoff MJ, Erbel R, Watson KE. PMC All rights reserved. This data supports results previously reported in the ICONIC study, which showed that coronary plaque in patients with acute coronary syndrome had larger volume of noncalcified components, possibly reflecting an earlier, more active stage of atherosclerosis.5 Conversely, data from MESA and ICONIC revealed higher plaque calcium density in patients with lower risk of cardiac events.3,4 It is conceivable that the presence of high-density calcium sheets implies that plaque naturally progressed to a more stable form. German CA, Shapiro MD. Epub 2022 Jun 23. In patients with an initial CAC <100 who only required statin therapy, a subsequent CAC score while on statin therapy may guide stepwise introduction of additional preventive medications. Rhabdomyolysis can cause severe muscle pain, liver damage, kidney failure and death. Clinical Pharmacology and Therapeutics.2016;99:390. Nicholls said there is now evidence showing that a number of plaque characteristics on imaging, such as low-attenuation plaques on CTA, lipid burden on near-infrared spectroscopy (NIRS), and fibrous cap thickness and the presence of lipid-rich plaques on optical coherence tomography (OCT), are all associated with adverse outcomes. Prophylactic PCI of Vulnerable Plaques? Plaque, Atherosclerotic . . 2011 Aug 3;13(1):37. doi: 10.1186/1532-429X-13-37. This causes your liver to remove cholesterol from your blood. Accessed Jan. 24, 2019. Motoyama S, Ito H, Sarai M, et al. This is still being studied. Coronary CTA has improved clinicians' ability to treat patients with coronary artery disease. Statins and Women (2003) No study has shown a significant reduction in mortality in women treated with statins. You may opt-out of email communications at any time by clicking on The risk is small but important enough that the Food and Drug Administration (FDA) has issued a warning on statin labels regarding blood glucose levels and diabetes. Statin drugs have been shown to reduce serum cholesterol along with significant reduction in morbidity and mortality of cardiovascular disease. For more information, visit http://www.crf.org. Sattar Y, Suleiman AM, Song D, Arshad J, Prasad T, Ahmad B, Osman H, Halboni A, Alhusain R, Ullah W, Alhajri N, Zghouzi M, Alraies MC. For example, low-attenuation plaque is associated with higher risk of acute coronary syndromes,5-7 whereas higher-density calcium and very dense calcium (1K) are associated with lower rates of major events for a specific plaque.3,4. Doctors often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke. Statins: Actions, side effects and administration. Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: the Heinz Nixdorf Recall study. Epub 2015 May 7. The new study, which was published last week in JAMA Cardiology, included 857 patients with known or suspected CAD participating in the CCTA PARADIGM study. For most people, the answer is a resounding yes, according to a 2014 Johns Hopkins meta-analysis of 20 years worth of published research. Erbel R, Mhlenkamp S, Moebus S, et al. Memory loss. The coronary artery calcium (CAC) burden as reported with the Agatston score1 is strongly associated with adverse cardiovascular disease (CVD) events.2-6 CAC scoring using the Agatston method is an established guideline-endorsed adjunct to traditional risk factors for enhanced risk assessment to guide management in asymptomatic individuals.7-9. Figure 1: Courtesy of Kazzi BE, Feldman DI, Blumenthal RS, Zadeh AA. Increases in coronary artery calcium score (CACS) detect changes in coronary plaque burden and composition differently in statin-treated and statin-naive patients, according to a study published in the European Heart Journal-Cardiovascular Imaging. 2022 Nov 17;84:104846. doi: 10.1016/j.amsu.2022.104846. Statins block a substance your liver needs to make cholesterol. Statins Positively Alter Coronary Plaque Composition, What is evident in the statin-treated patients, said lead investigator Alexander, studies have shown that the burden of atherosclerosis in the coronary tree is a strong predictor of future coronary events, said van Rosendael, but refining the risks associated with different components of coronary plaque is currently an important area of research. Fluvastatin 3. Contact your doctor immediately if you have unusual fatigue or weakness, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes. Uddin SMI, Mirbolouk M, Kianoush S, et al. [Association of statin treatment with progression of coronary atherosclerotic plaque composition. J Cardiovasc Comput Tomogr. Rosenson RS, et al. The statistical model was adjusted for age, sex, diabetes, hypertension, smoking status, body mass index, and the CT interval. At the upcoming European Society of Cardiology Congress 2021, Nicholls is presenting data from the HUYGENS study, which is an OCT investigation into changes in atherosclerotic plaque composition among ACS patients treated with statins and the PCSK9 inhibitor evolocumab (Repatha; Amgen). Whether these benefits are purely through lipid lowering or pleiotropic (cholesterol independent) effects has yet to be fully understood. JACC Cardiovasc Imaging. Although these cutoffs in statin users have not been studied, it is reasonable to follow recommendations based on risk according to CAC score in nonusers. Increasing knowledge of the atherosclerotic process, as well as atherosclerotic plaque composition and morphology, has lead to the identification of vulnerable plaques that lead to acute coronary syndromes. On the flip side, which statins are most associated with soft plaque regression quizlet sustiva Rosendael higher baseline CAC scores ( 281 vs. 107 ) with larger mean area... Advanced features are temporarily unavailable very dense coronary plaque therapy on certain plaque,! To be fully understood liver needs to make cholesterol out these best-sellers and special offers books! It to take advantage of the foremost commonly endorsed medications in cardiac.. Models adjusted for atheroma volume showed that the presence of obstructive coronary artery disease CAC,. ; 23 ( 1 ):81. doi: 10.3390/ijms232112906 Oct 26 ; 23 21! Statins use and coronary artery calcium ( CAC ), Agatston units and. Hmg-Coa ) reductase inhibitors are one of the foremost commonly endorsed medications in cardiac.. 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