Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Assessing the Impact of Long-term High-Dose Statin Treatment on Pericoronary Inflammation and Plaque Distribution - a Comprehensive Coronary CTA Follow-up Study

Botond-Barna Mátyás
ORCID logo ,
Imre Benedek
,
Nóra Raț
* ,
Emanuel Blîndu
,
Zsolt Parajkó
,
Theofana Mihăilă
,
Theodora Benedek
Version 1 : Received: 4 January 2024 / Approved: 4 January 2024 / Online: 4 January 2024 (09:56:00 CET)

A peer-reviewed article of this Preprint also exists.

Mátyás, B.B.; Benedek, I.; Raț, N.; Blîndu, E.; Parajkó, Z.; Mihăilă, T.; Benedek, T. Assessing the Impact of Long-Term High-Dose Statin Treatment on Pericoronary Inflammation and Plaque Distribution—A Comprehensive Coronary CTA Follow-Up Study. Int. J. Mol. Sci. 2024, 25, 1700. Mátyás, B.B.; Benedek, I.; Raț, N.; Blîndu, E.; Parajkó, Z.; Mihăilă, T.; Benedek, T. Assessing the Impact of Long-Term High-Dose Statin Treatment on Pericoronary Inflammation and Plaque Distribution—A Comprehensive Coronary CTA Follow-Up Study. Int. J. Mol. Sci. 2024, 25, 1700.

Abstract

(1) Background: CTA has validated the use of pericoronary adipose tissue (PCAT) attenuation as a credible indicator of coronary inflammation and plays a crucial role in coronary artery disease (CAD). This study aimed to evaluate the long-term effects of high-dose statins on PCAT attenuation at coronary lesion sites and changes in plaque distribution; (2) Methods: Our prospective observational study included 52 patients (mean age 60.43) with typical chest pain, a low-to-intermediate likelihood of CAD, and documented atheromatous plaque through CCT. We utilized advanced features of the CaRi-Heart® and syngo.via Frontier® systems to assess coronary plaques and changes in PCAT attenuation; (3) Results: Changes in plaque morphology were investigated, revealing significant alterations. Notably, in mixed plaques, calcified portions increased (p < 0.0001), while non-calcified plaque volume (NCPV) decreased (p = 0.0209). PCAT attenuation generally decreased after one year and remained low, indicating reduced inflammation in the following arteries: LAD (p = 0.0142), LCX (p = 0.0513), and RCA (p = 0.1249). The CaRi-Heart® risk also decreased significantly (p = 0.0041). Linear regression analysis demonstrated a correlation between increased PCAT attenuation and higher volumes of NCPV (p < 0.0001, r = 0.3032) and lipid-rich plaque volume (p < 0.0001, r = 0.3281); (4) Conclusions: Our study provides evidence that high-dose statin therapy significantly reduces CAD risk factors, inflammation, and plaque vulnerability, as evidenced by the notable decrease in PCAT attenuation, a critical indicator of plaque progression.

Keywords

pericoronary adipose tissue inflammation; computed tomography angiography; fat attenuation index score; atherosclerosis; coronary artery disease; high-dose statin

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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