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Published in: BMC Cardiovascular Disorders 1/2020

Open Access 01-12-2020 | Atorvastatin | Research article

Effect of cholesterol re-supplementation and atorvastatin on plaque composition in the thoracic aorta of New Zealand white rabbits

Authors: G. A. Bonaterra, K. Bender, B. Wilhelm, H. Schwarzbach, S. Metz, O. Kelber, D. Weiser, J. Metz, R. Kinscherf

Published in: BMC Cardiovascular Disorders | Issue 1/2020

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Abstract

Background

Effects of re-supplementation of a cholesterol-enriched diet (CEDrs) on size, cholesterol content and morphology of already existing plaques are not known to date.

Methods

A group of rabbits received standard chow (SC) for 6 weeks (“negative control”; for plasma lipid measurements only). Group I-IV received 2% CED (induction) for 6 weeks; thereafter, groups II-IV have been fed a SC (= cholesterol withdrawal) for 68 weeks. Afterwards, feeding of groups II-IV was continued as follows: Group II - 10 weeks SC, group III - 4 weeks 0.5% CED (~re-supplementation), afterwards 6 weeks SC (~withdrawal again); group IV - 4 weeks 0.5% CED (re-supplementation) + atorvastatin (2.5 mg/kg body weight/day), afterwards 6 weeks SC (~withdrawal again) + atorvastatin. Plasma lipids, but also plaque size, morphology and cholesterol contents of thoracic aortas were quantified.

Results

After CEDrs, plasma cholesterol levels were increased. However, after withdrawal of CEDrs, plasma cholesterol levels decreased, whereas the cholesterol content of the thoracic aorta was increased in comparison with the group without CEDrs. Plaque size remained unaffected. Atorvastatin application did not change plasma cholesterol level, cholesterol content of the thoracic aorta and plaque size in comparison with the group without drug treatment. However, atorvastatin treatment increased the density of macrophages (MΦ) compared with the group without treatment, with a significant correlation between densities of MΦ (Mac-1+) and apoptotic (TUNEL+; TP53+), antigen-presenting (HLA-DR+) or oxidatively stressed (SOD2+) cells.

Conclusions

In rabbits with already existing plaques, CEDrs affects plaque morphology and cellular composition, but not plaque size. Despite missing effects on plasma cholesterol levels, cholesterol content of the thoracic aorta and size of already existing atherosclerotic plaques, atorvastatin treatment transforms the already existing lesions to a more active form, which may accelerate the remodelling to a more stable plaque.
Literature
1.
go back to reference Mach F, Baigent C, Catapano AL, Koskinas KC, Casul M, Badimon L, et al. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: the task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European atherosclerosis society (EAS). Eur Heart J. 2020;41:111–88.PubMedCrossRef Mach F, Baigent C, Catapano AL, Koskinas KC, Casul M, Badimon L, et al. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: the task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European atherosclerosis society (EAS). Eur Heart J. 2020;41:111–88.PubMedCrossRef
2.
go back to reference Anitschkow N, Chalatow S. Ueber experimentelle cholesterinsteatose und ihre bedeutung für die entstehung einiger pathologischer prozesse. Zbl Allg Path path Anat. 1913;24:1–9. Anitschkow N, Chalatow S. Ueber experimentelle cholesterinsteatose und ihre bedeutung für die entstehung einiger pathologischer prozesse. Zbl Allg Path path Anat. 1913;24:1–9.
3.
go back to reference Gonçalves I, Andersson Georgiadou E, Mattsson S, Skog G, Pedro L, Fernandes e Fernandes J, et al. Direct association between diet and the stability of human atherosclerotic plaque. Sci Rep. 2015;5:15524. Gonçalves I, Andersson Georgiadou E, Mattsson S, Skog G, Pedro L, Fernandes e Fernandes J, et al. Direct association between diet and the stability of human atherosclerotic plaque. Sci Rep. 2015;5:15524.
4.
go back to reference Emini Veseli B, Perrotta P, De Meyer GRA, Roth L, Van der Donckt C, Martinet W, et al. Animal models of atherosclerosis. Eur J Pharmacol. 2017;816:3–13.PubMedCrossRef Emini Veseli B, Perrotta P, De Meyer GRA, Roth L, Van der Donckt C, Martinet W, et al. Animal models of atherosclerosis. Eur J Pharmacol. 2017;816:3–13.PubMedCrossRef
5.
go back to reference Friedman M, Byers SO, Rosenman RH. Resolution of aortic atherosclerotic infiltration in the rabbit by phosphatide infusion. Proc Soc Exp Biol Med. 1957;95:586–8.PubMedCrossRef Friedman M, Byers SO, Rosenman RH. Resolution of aortic atherosclerotic infiltration in the rabbit by phosphatide infusion. Proc Soc Exp Biol Med. 1957;95:586–8.PubMedCrossRef
6.
go back to reference Chistiakov DA, Myasoedova VA, Revin VV, Orekhov AN, Bobryshev YV. The phenomenon of atherosclerosis reversal and regression: lessons from animal models. Exp Mol Pathol. 2017;102:138–45.PubMedCrossRef Chistiakov DA, Myasoedova VA, Revin VV, Orekhov AN, Bobryshev YV. The phenomenon of atherosclerosis reversal and regression: lessons from animal models. Exp Mol Pathol. 2017;102:138–45.PubMedCrossRef
7.
go back to reference Hartung D, Sarai M, Petrov A, Kolodgie F, Narula N, Verjans J, et al. Resolution of apoptosis in atherosclerotic plaque by dietary modification and statin therapy. J Nucl Med. 2005;46:2051–6.PubMed Hartung D, Sarai M, Petrov A, Kolodgie F, Narula N, Verjans J, et al. Resolution of apoptosis in atherosclerotic plaque by dietary modification and statin therapy. J Nucl Med. 2005;46:2051–6.PubMed
8.
go back to reference Libby P. Current concepts of the pathogenesis of the acute coronary circulating levels of ox-LDL are increased in patients with syndromes. Circulation. 2001;104:365–72.PubMedCrossRef Libby P. Current concepts of the pathogenesis of the acute coronary circulating levels of ox-LDL are increased in patients with syndromes. Circulation. 2001;104:365–72.PubMedCrossRef
9.
go back to reference Tang J, Lobatto ME, Hassing L, van der Staay S, van Rijs SM, Calcagno C, et al. Inhibiting macrophage proliferation suppresses atherosclerotic plaque inflammation. Sci Adv. 2015;1:e1400223.PubMedPubMedCentralCrossRef Tang J, Lobatto ME, Hassing L, van der Staay S, van Rijs SM, Calcagno C, et al. Inhibiting macrophage proliferation suppresses atherosclerotic plaque inflammation. Sci Adv. 2015;1:e1400223.PubMedPubMedCentralCrossRef
11.
go back to reference Barrett TJ. Macrophages in atherosclerosis regression. Arterioscler Thromb Vasc Biol. 2020;40(1):20–33.PubMedCrossRef Barrett TJ. Macrophages in atherosclerosis regression. Arterioscler Thromb Vasc Biol. 2020;40(1):20–33.PubMedCrossRef
13.
go back to reference Moore KJ, Koplev S, Fisher EA, Tabas I, Bjorkegren JLM, Doran AC, et al. Macrophage trafficking, inflammatory resolution, and genomics in atherosclerosis: JACC macrophage in CVD series (Part 2). J Am Coll Cardiol. 2018;72:2181–97.PubMedPubMedCentralCrossRef Moore KJ, Koplev S, Fisher EA, Tabas I, Bjorkegren JLM, Doran AC, et al. Macrophage trafficking, inflammatory resolution, and genomics in atherosclerosis: JACC macrophage in CVD series (Part 2). J Am Coll Cardiol. 2018;72:2181–97.PubMedPubMedCentralCrossRef
14.
go back to reference Ammirati E, Moroni F, Norata GD, Magnoni M, Camici PG. Markers of inflammation associated with plaque progression and instability in patients with carotid atherosclerosis. Mediat Inflamm. 2015;2015:718329.CrossRef Ammirati E, Moroni F, Norata GD, Magnoni M, Camici PG. Markers of inflammation associated with plaque progression and instability in patients with carotid atherosclerosis. Mediat Inflamm. 2015;2015:718329.CrossRef
15.
go back to reference Kinscherf R, Kamencic H, Deigner HP, Pill J, Schmiedt W, Schrader M, et al. Effect of alterations of blood cholesterol levels on macrophages in the myocardium of New Zealand white rabbits. J Leukoc Biol. 1997;62:719–25.PubMedCrossRef Kinscherf R, Kamencic H, Deigner HP, Pill J, Schmiedt W, Schrader M, et al. Effect of alterations of blood cholesterol levels on macrophages in the myocardium of New Zealand white rabbits. J Leukoc Biol. 1997;62:719–25.PubMedCrossRef
16.
go back to reference Borén J, Chapman MJ, Krauss RM, Packard CJ, Bentzon JF, Binder CJ, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European atherosclerosis society consensus panel. Eur Heart J. 2020;41(24):2313–30.PubMedPubMedCentralCrossRef Borén J, Chapman MJ, Krauss RM, Packard CJ, Bentzon JF, Binder CJ, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European atherosclerosis society consensus panel. Eur Heart J. 2020;41(24):2313–30.PubMedPubMedCentralCrossRef
18.
go back to reference Williams JW, Giannarelli C, Rahman A, Randolph GJ, Kovacic JC. Macrophage biology, classification, and phenotype in cardiovascular disease: JACC macrophage in CVD series (Part 1). J Am Coll Cardiol. 2018;72:2166–80.PubMedPubMedCentralCrossRef Williams JW, Giannarelli C, Rahman A, Randolph GJ, Kovacic JC. Macrophage biology, classification, and phenotype in cardiovascular disease: JACC macrophage in CVD series (Part 1). J Am Coll Cardiol. 2018;72:2166–80.PubMedPubMedCentralCrossRef
19.
go back to reference Puri R, Nissen SE, Shao M, Ballantyne CM, Barter PJ, Chapman MJ, et al. Antiatherosclerotic effects of long-term maximally intensive statin therapy after acute coronary syndrome: insights from study of coronary atheroma by intravascular ultrasound: effect of Rosuvastatin versus atorvastatin. Arterioscler Thromb Vasc Biol. 2014;34:2465–72.PubMedCrossRef Puri R, Nissen SE, Shao M, Ballantyne CM, Barter PJ, Chapman MJ, et al. Antiatherosclerotic effects of long-term maximally intensive statin therapy after acute coronary syndrome: insights from study of coronary atheroma by intravascular ultrasound: effect of Rosuvastatin versus atorvastatin. Arterioscler Thromb Vasc Biol. 2014;34:2465–72.PubMedCrossRef
21.
go back to reference Stegman B, Shao M, Nicholls SJ, Elshazly M, Cho L, King P, et al. Coronary atheroma progression rates in men and women following high-intensity statin therapy: a pooled analysis of REVERSAL ASTERIOD and SATURN. Atherosclerosis. 2016;254:78–84.PubMedCrossRef Stegman B, Shao M, Nicholls SJ, Elshazly M, Cho L, King P, et al. Coronary atheroma progression rates in men and women following high-intensity statin therapy: a pooled analysis of REVERSAL ASTERIOD and SATURN. Atherosclerosis. 2016;254:78–84.PubMedCrossRef
22.
go back to reference Janić M, Lunder M, Zupan J, Černe D, Marc J, Drevenšek G, et al. The low-dose atorvastatin and valsartan combination effectively protects the arterial wall from atherogenic diet-induced impairment in the Guinea pig. Eur J Pharmacol. 2014;743:31–6.PubMedCrossRef Janić M, Lunder M, Zupan J, Černe D, Marc J, Drevenšek G, et al. The low-dose atorvastatin and valsartan combination effectively protects the arterial wall from atherogenic diet-induced impairment in the Guinea pig. Eur J Pharmacol. 2014;743:31–6.PubMedCrossRef
23.
go back to reference Nasr SH, Rashidijahanabad Z, Ramadan S, Kauffman N, Parameswaran N, Zinn KR, et al. Effective atherosclerotic plaque inflammation inhibition with targeted drug delivery by hyaluronan conjugated atorvastatin nanoparticles. Nanoscale. 2020;12(17):9541–56.CrossRefPubMedCentral Nasr SH, Rashidijahanabad Z, Ramadan S, Kauffman N, Parameswaran N, Zinn KR, et al. Effective atherosclerotic plaque inflammation inhibition with targeted drug delivery by hyaluronan conjugated atorvastatin nanoparticles. Nanoscale. 2020;12(17):9541–56.CrossRefPubMedCentral
24.
go back to reference Riedmüller K, Metz S, Bonaterra GA, Kelber O, Weiser D, Metz J, et al. Cholesterol diet and effect of long-term withdrawal on plaque development and composition in the thoracic aorta of New Zealand white rabbits. Atherosclerosis. 2010;210(2):407–13.PubMedCrossRef Riedmüller K, Metz S, Bonaterra GA, Kelber O, Weiser D, Metz J, et al. Cholesterol diet and effect of long-term withdrawal on plaque development and composition in the thoracic aorta of New Zealand white rabbits. Atherosclerosis. 2010;210(2):407–13.PubMedCrossRef
25.
go back to reference National Research Council (US) Committee for the Update of the Guide for the Care and Use of Laboratory Animals. Guide for the Care and Use of Laboratory Animals. 8th ed. Washington (DC): National Academies Press (US); 2011. National Research Council (US) Committee for the Update of the Guide for the Care and Use of Laboratory Animals. Guide for the Care and Use of Laboratory Animals. 8th ed. Washington (DC): National Academies Press (US); 2011.
26.
go back to reference Folch J, Ascoli I, Lees M, Meath JA, LeBaron FN. Preparation of lipid extracts from brain tissue. J Biol Chem. 1951;191:833–40.PubMed Folch J, Ascoli I, Lees M, Meath JA, LeBaron FN. Preparation of lipid extracts from brain tissue. J Biol Chem. 1951;191:833–40.PubMed
27.
go back to reference Schlittenhardt D, Schmiedt W, Bonaterra GA, Metz J, Kinscherf R. Colocalization of oxidized low-density lipoprotein, caspase-3, cyclooxygenase-2, and macrophage migration inhibitory factor in arteriosclerotic human carotid arteries. Cell Tissue Res. 2005;322:425–35.PubMedCrossRef Schlittenhardt D, Schmiedt W, Bonaterra GA, Metz J, Kinscherf R. Colocalization of oxidized low-density lipoprotein, caspase-3, cyclooxygenase-2, and macrophage migration inhibitory factor in arteriosclerotic human carotid arteries. Cell Tissue Res. 2005;322:425–35.PubMedCrossRef
28.
go back to reference Metz J, Schmelz A, Pavlov P. Morphologische Untersuchungen zur Quantifizierung der Arteriosklerose. Z Gerontol. 1990;23:140–2.PubMed Metz J, Schmelz A, Pavlov P. Morphologische Untersuchungen zur Quantifizierung der Arteriosklerose. Z Gerontol. 1990;23:140–2.PubMed
29.
go back to reference Ji J, Pan E, Li J, Chen J, Cao J, Sun D, et al. Classical risk factors of cardiovascular disease among Chinese male steel workers: a prospective cohort study for 20 years. BMC Public Health. 2011;11:497.PubMedPubMedCentralCrossRef Ji J, Pan E, Li J, Chen J, Cao J, Sun D, et al. Classical risk factors of cardiovascular disease among Chinese male steel workers: a prospective cohort study for 20 years. BMC Public Health. 2011;11:497.PubMedPubMedCentralCrossRef
30.
go back to reference Bohula EA, Giugliano RP, Leiter LA, Verma S, Park JG, Sever PS, et al. Inflammatory and cholesterol risk in the FOURIER trial. Circulation. 2018;138:131–40.PubMedCrossRef Bohula EA, Giugliano RP, Leiter LA, Verma S, Park JG, Sever PS, et al. Inflammatory and cholesterol risk in the FOURIER trial. Circulation. 2018;138:131–40.PubMedCrossRef
31.
go back to reference Fan J, Kitajima S, Watanabe T, Xu J, Zhang J, Liu E, et al. Rabbit models for the study of human atherosclerosis: from pathophysiological mechanisms to translational medicine. Pharmacol Therapeut. 2015;146:104–19.CrossRef Fan J, Kitajima S, Watanabe T, Xu J, Zhang J, Liu E, et al. Rabbit models for the study of human atherosclerosis: from pathophysiological mechanisms to translational medicine. Pharmacol Therapeut. 2015;146:104–19.CrossRef
32.
go back to reference Luo F, Guo Y, Ruan GY, Long JK, Zheng XL, Xia Q, et al. Combined use of metformin and atorvastatin attenuates atherosclerosis in rabbits fed a high-cholesterol diet. Sci Rep. 2017;7:2169.PubMedPubMedCentralCrossRef Luo F, Guo Y, Ruan GY, Long JK, Zheng XL, Xia Q, et al. Combined use of metformin and atorvastatin attenuates atherosclerosis in rabbits fed a high-cholesterol diet. Sci Rep. 2017;7:2169.PubMedPubMedCentralCrossRef
33.
go back to reference Prasad K. Regression of hypercholesterolemic atherosclerosis in rabbits by se coisolariciresinol diglucoside isolated from flaxseed. Atherosclerosis. 2008;197:34–42.PubMedCrossRef Prasad K. Regression of hypercholesterolemic atherosclerosis in rabbits by se coisolariciresinol diglucoside isolated from flaxseed. Atherosclerosis. 2008;197:34–42.PubMedCrossRef
34.
go back to reference Hegyi L, Hockings PD, Benson MG, Busza AL, Overend P, Grimsditch DC, et al. Short term arterial remodelling in the aortae of cholesterol fed New Zealand white rabbits shown in vivo by highresolution magnetic resonance imaging – implications for human pathology. Pathol Oncol Res. 2004;10:159–65.PubMedCrossRef Hegyi L, Hockings PD, Benson MG, Busza AL, Overend P, Grimsditch DC, et al. Short term arterial remodelling in the aortae of cholesterol fed New Zealand white rabbits shown in vivo by highresolution magnetic resonance imaging – implications for human pathology. Pathol Oncol Res. 2004;10:159–65.PubMedCrossRef
35.
go back to reference Brown G, Albers JJ, Fisher LD, Schaefer SM, Lin J-T, Kaplan C, et al. Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B. New Engl J Med. 1990;323:1289–98.PubMedCrossRef Brown G, Albers JJ, Fisher LD, Schaefer SM, Lin J-T, Kaplan C, et al. Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B. New Engl J Med. 1990;323:1289–98.PubMedCrossRef
37.
go back to reference Watanabe T, Hirata M, Yoshikawa Y, Nagafuchi Y, Toyoshima H, Watanabe T. Role of macrophages in atherosclerosis. Sequential observations of cholesterol-induced rabbit aortic lesion by the immunoperoxidase technique using monoclonal anti-macrophage antibody. Lab Investig. 1985;53:80–90.PubMed Watanabe T, Hirata M, Yoshikawa Y, Nagafuchi Y, Toyoshima H, Watanabe T. Role of macrophages in atherosclerosis. Sequential observations of cholesterol-induced rabbit aortic lesion by the immunoperoxidase technique using monoclonal anti-macrophage antibody. Lab Investig. 1985;53:80–90.PubMed
38.
go back to reference Tabas I. Apoptosis and plaque destabilization in atherosclerosis: the role of macrophage apoptosis induced by cholesterol. Cell Death Differ. 2004;11:12–6.CrossRef Tabas I. Apoptosis and plaque destabilization in atherosclerosis: the role of macrophage apoptosis induced by cholesterol. Cell Death Differ. 2004;11:12–6.CrossRef
40.
go back to reference Kinscherf R, Wagner M, Kamencic H, Bonaterra GA, Hou D, Schiele RA, et al. Characterization of apoptotic macrophages in atheromatous tissue of humans and heritable hyperlipidemic rabbits. Atherosclerosis. 1999;144:33–9.PubMedCrossRef Kinscherf R, Wagner M, Kamencic H, Bonaterra GA, Hou D, Schiele RA, et al. Characterization of apoptotic macrophages in atheromatous tissue of humans and heritable hyperlipidemic rabbits. Atherosclerosis. 1999;144:33–9.PubMedCrossRef
41.
go back to reference Guevara NV, Kim HS, Antonova EI, Chan L. The absence of p53 accelerates atherosclerosis by increasing cell proliferation in vivo. Nat Med. 1999;5:335–9.PubMedCrossRef Guevara NV, Kim HS, Antonova EI, Chan L. The absence of p53 accelerates atherosclerosis by increasing cell proliferation in vivo. Nat Med. 1999;5:335–9.PubMedCrossRef
42.
go back to reference Shiomi M, Yamada S, Ito T. Atheroma stabilizing effects of simvastatin due to depression of macrophages or lipid accumulation in the atheromatous plaques of coronary plaque prone WHHL rabbits. Atherosclerosis. 2005;178:287–94.PubMedCrossRef Shiomi M, Yamada S, Ito T. Atheroma stabilizing effects of simvastatin due to depression of macrophages or lipid accumulation in the atheromatous plaques of coronary plaque prone WHHL rabbits. Atherosclerosis. 2005;178:287–94.PubMedCrossRef
43.
go back to reference Daoud AS, Fritz KE, Jarmolych J, Frank AS. Role of macrophages in regression of atherosclerosis. Ann N Y Acad Sci. 1985;454:101–14.PubMedCrossRef Daoud AS, Fritz KE, Jarmolych J, Frank AS. Role of macrophages in regression of atherosclerosis. Ann N Y Acad Sci. 1985;454:101–14.PubMedCrossRef
44.
go back to reference Verhamme P, Quarck R, Hao H, Knaapen M, Dymarkowski S, Bernar H, et al. Dietary cholesterol withdrawal reduces vascular inflammation and induces coronary plaque stabilization in miniature pigs. Cardiovasc Res. 2002;56:135–44.PubMedCrossRef Verhamme P, Quarck R, Hao H, Knaapen M, Dymarkowski S, Bernar H, et al. Dietary cholesterol withdrawal reduces vascular inflammation and induces coronary plaque stabilization in miniature pigs. Cardiovasc Res. 2002;56:135–44.PubMedCrossRef
45.
go back to reference Francis AA, Deniset JF, Austria JA, LaValleé RK, Maddaford GG, Hedley TE, et al. Effects of dietary flaxseed on atherosclerotic plaque regression. Am J Physiol Heart Circ Physiol. 2013;304(12):H1743–51.PubMedCrossRef Francis AA, Deniset JF, Austria JA, LaValleé RK, Maddaford GG, Hedley TE, et al. Effects of dietary flaxseed on atherosclerotic plaque regression. Am J Physiol Heart Circ Physiol. 2013;304(12):H1743–51.PubMedCrossRef
47.
go back to reference Puri R, Libby P, Nissen SE, Wolski K, Ballantyne CM, Barter PJ, et al. Long-term effects of maximally intensive statin therapy on changes in coronary atheroma composition: insights from SATURN. Eur Hear J Cardiovasc Imag. 2014;15:380–8.CrossRef Puri R, Libby P, Nissen SE, Wolski K, Ballantyne CM, Barter PJ, et al. Long-term effects of maximally intensive statin therapy on changes in coronary atheroma composition: insights from SATURN. Eur Hear J Cardiovasc Imag. 2014;15:380–8.CrossRef
48.
go back to reference Puri R, Nicholls SJ, Shao M, Kataoka Y, Uno K, Kapadia SR, et al. Impact of statins on serial coronary calcification during atheroma progression and regression. J Am Coll Cardiol. 2015;65:1273–82.PubMedCrossRef Puri R, Nicholls SJ, Shao M, Kataoka Y, Uno K, Kapadia SR, et al. Impact of statins on serial coronary calcification during atheroma progression and regression. J Am Coll Cardiol. 2015;65:1273–82.PubMedCrossRef
49.
go back to reference Bayturan O, Kapadia S, Nicholls SJ, Tuzcu EM, Shao M, Uno K, Shreevatsa A, Lavoie AJ, Wolski K, Schoenhagen P, Nissen SE. Clinical predictors of plaque progression despite very low levels of low-density lipoprotein cholesterol. J Am Coll Cardiol. 2010;55:2736–42.PubMedCrossRef Bayturan O, Kapadia S, Nicholls SJ, Tuzcu EM, Shao M, Uno K, Shreevatsa A, Lavoie AJ, Wolski K, Schoenhagen P, Nissen SE. Clinical predictors of plaque progression despite very low levels of low-density lipoprotein cholesterol. J Am Coll Cardiol. 2010;55:2736–42.PubMedCrossRef
50.
go back to reference Gragnano F, Calabrò P. Role of dual lipid-lowering therapy in coronary atherosclerosis regression: evidence from recent studies. Atherosclerosis. 2018;269:219–28.PubMedCrossRef Gragnano F, Calabrò P. Role of dual lipid-lowering therapy in coronary atherosclerosis regression: evidence from recent studies. Atherosclerosis. 2018;269:219–28.PubMedCrossRef
51.
go back to reference Navarese EP, Kolodziejczak M, Winter M-P, Alimohammadi A, Lang IM, Buffon A, et al. Association of PCSK9 with platelet reactivity in patients with acute coronary syndrome treated with prasugrel or ticagrelor: the PCSK9-REACT study. Int J Cardiol. 2017;227:644–9.PubMedCrossRef Navarese EP, Kolodziejczak M, Winter M-P, Alimohammadi A, Lang IM, Buffon A, et al. Association of PCSK9 with platelet reactivity in patients with acute coronary syndrome treated with prasugrel or ticagrelor: the PCSK9-REACT study. Int J Cardiol. 2017;227:644–9.PubMedCrossRef
52.
go back to reference Cesaro A, Bianconi V, Gragnano F, Moscarella E, Fimiani F, Monda E, et al. Beyond cholesterol metabolism: the pleiotropic effects of proprotein convertase subtil-isin/kexin type 9 (PCSK9). Genetics, mutations, expression, and perspective for long-term inhibition. Biofactors. 2020;46(3):367–80.PubMedCrossRef Cesaro A, Bianconi V, Gragnano F, Moscarella E, Fimiani F, Monda E, et al. Beyond cholesterol metabolism: the pleiotropic effects of proprotein convertase subtil-isin/kexin type 9 (PCSK9). Genetics, mutations, expression, and perspective for long-term inhibition. Biofactors. 2020;46(3):367–80.PubMedCrossRef
53.
go back to reference Cheng JM, Oemrawsingh RM, Garcia-Garcia HM, Boersma E, van Geuns R-J, Serruys PW, et al. PCSK9 in relation to coronary plaque inflammation: results of the ATHEROREMO-IVUS study. Atherosclerosis. 2016;248:117–22.PubMedCrossRef Cheng JM, Oemrawsingh RM, Garcia-Garcia HM, Boersma E, van Geuns R-J, Serruys PW, et al. PCSK9 in relation to coronary plaque inflammation: results of the ATHEROREMO-IVUS study. Atherosclerosis. 2016;248:117–22.PubMedCrossRef
54.
go back to reference Hadjiphilippou S, Ray KK. PCSK9 inhibition and atherosclerotic cardiovascular disease prevention: does reality match the hype? Heart. 2017;103:1670–9.PubMedCrossRef Hadjiphilippou S, Ray KK. PCSK9 inhibition and atherosclerotic cardiovascular disease prevention: does reality match the hype? Heart. 2017;103:1670–9.PubMedCrossRef
Metadata
Title
Effect of cholesterol re-supplementation and atorvastatin on plaque composition in the thoracic aorta of New Zealand white rabbits
Authors
G. A. Bonaterra
K. Bender
B. Wilhelm
H. Schwarzbach
S. Metz
O. Kelber
D. Weiser
J. Metz
R. Kinscherf
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2020
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-020-01703-x

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