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Introduction: Non-statin therapy (NST) is used as second-line treatment when statin monotherapy is inadequate or poorly tolerated.

Objective: To determine the association of NST with plaque composition, alone or in combination with statins, in patients undergoing coronary computed tomography angiography (coronary CTA).

Methods: From the multicenter CONFIRM registry, we analyzed individuals who underwent coronary CTA with known lipid-lowering therapy status and without prior coronary artery disease at baseline. We created a propensity score for being on NST, followed by stepwise multivariate linear regression, adjusting for the propensity score as well as risk factors, to determine the association between NST and the number of coronary artery segments with each plaque type (non-calcified (NCP), partially calcified (PCP) or calcified (CP)) and segment stenosis score (SSS).

Results: Of the 27,125 subjects in CONFIRM, 4,945 met the inclusion criteria; 371 (7.5%) took NST. At baseline, patients on NST had more prevalent risk factors and were more likely to be on concomitant cardiac medications. After multivariate and propensity score adjustment, NST was not associated with plaque composition: NCP (0.07 increase, 95% CI: -0.05, 0.20; p = 0.26), PCP (0.10 increase, 95% CI: -0.10, 0.31; p = 0.33), CP (0.18 increase, 95% CI: -0.10, 0.46; p = 0.21) or SSS (0.45 increase, 95% CI: -0.02,0.93; p = 0.06). The absence of an effect of NST on plaque type was not modified by statin use (p for interaction > 0.05 for all).

Conclusion: In this cross-sectional study, non-statin therapy was not associated with differences in plaque composition as assessed by coronary CTA.

Titel:	A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography.
Autor/in / Beteiligte Person:	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 Araújo Gonçalves P ; Rubinshtein, R ; Achenbach, S ; Chang, HJ ; Chow, BJW ; Cury, R ; Lu, Y ; Bax, JJ ; Jones, EC ; Peña, JM ; Shaw, LJ ; Min, JK ; Lin, FY
Zeitschrift:	Journal of cardiovascular computed tomography, Jg. 13 (2019-03-01), Heft 2, S. 99-104
Veröffentlichung:	Cambridge, MA : Elsevier, 2019
Medientyp:	academicJournal
ISSN:	1876-861X (electronic)
DOI:	10.1016/j.jcct.2019.01.015
Schlagwort:	Aged Asia epidemiology Biomarkers blood Coronary Artery Disease epidemiology Coronary Artery Disease pathology Coronary Artery Disease prevention & control Coronary Stenosis epidemiology Coronary Stenosis pathology Coronary Stenosis prevention & control Coronary Vessels pathology Cross-Sectional Studies Drug Therapy, Combination Dyslipidemias blood Dyslipidemias diagnosis Dyslipidemias epidemiology Europe epidemiology Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use Male Middle Aged North America epidemiology Predictive Value of Tests Prevalence Registries Risk Factors Computed Tomography Angiography Coronary Angiography methods Coronary Artery Disease diagnostic imaging Coronary Stenosis diagnostic imaging Coronary Vessels diagnostic imaging Dyslipidemias drug therapy Hypolipidemic Agents therapeutic use Lipids blood Plaque, Atherosclerotic
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Multicenter Study Language: English [J Cardiovasc Comput Tomogr] 2019 Mar - Apr; Vol. 13 (2), pp. 99-104. <i>Date of Electronic Publication: </i>2019 Jan 29. MeSH Terms: Computed Tomography Angiography* ; Plaque, Atherosclerotic* ; Coronary Angiography / methods ; Coronary Artery Disease / diagnostic imaging ; Coronary Stenosis / diagnostic imaging ; Coronary Vessels / diagnostic imaging ; Dyslipidemias / drug therapy ; Hypolipidemic Agents / therapeutic use ; Lipids / *blood ; Aged ; Asia / epidemiology ; Biomarkers / blood ; Coronary Artery Disease / epidemiology ; Coronary Artery Disease / pathology ; Coronary Artery Disease / prevention & control ; Coronary Stenosis / epidemiology ; Coronary Stenosis / pathology ; Coronary Stenosis / prevention & control ; Coronary Vessels / pathology ; Cross-Sectional Studies ; Drug Therapy, Combination ; Dyslipidemias / blood ; Dyslipidemias / diagnosis ; Dyslipidemias / epidemiology ; Europe / epidemiology ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use ; Male ; Middle Aged ; North America / epidemiology ; Predictive Value of Tests ; Prevalence ; Registries ; Risk Factors Contributed Indexing: Keywords: Coronary computed tomography angiography; Coronary plaque composition; Ezetimibe; Fibrate; Niacin; Non-statin therapy Substance Nomenclature: 0 (Biomarkers) ; 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) ; 0 (Hypolipidemic Agents) ; 0 (Lipids) Entry Date(s): Date Created: 20190213 Date Completed: 20190612 Latest Revision: 20190613 Update Code: 20231215

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A cross-sectional survey of coronary plaque composition in individuals on non-statin lipid lowering drug therapies and undergoing coronary computed tomography angiography.