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Published in: BMC Medicine 1/2015

Open Access 01-12-2015 | Research article

Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies

Authors: Maciej Banach, Corina Serban, Amirhossein Sahebkar, Dimitri P. Mikhailidis, Sorin Ursoniu, Kausik K. Ray, Jacek Rysz, Peter P. Toth, Paul Muntner, Svetlana Mosteoru, Hector M. García-García, G. Kees Hovingh, John JP Kastelein, Patrick W. Serruys, Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group

Published in: BMC Medicine | Issue 1/2015

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Abstract

Background

Virtual histology intravascular ultrasound (VH-IVUS) imaging is an innovative tool for the morphological evaluation of coronary atherosclerosis. Evidence for the effects of statin therapy on VH-IVUS parameters have been inconclusive. Consequently, we performed a systematic review and meta-analysis to investigate the impact of statin therapy on plaque volume and its composition using VH-IVUS.

Methods

The search included PubMed, Cochrane Library, Scopus and Embase (through 30 November 2014) to identify prospective studies investigating the effects of statin therapy on plaque volume and its composition using VH-IVUS.

Results

We identified nine studies with 16 statin treatment arms and 830 participants. There was a significant effect of statin therapy in reducing plaque volume (standardized mean difference (SMD): −0.137, 95 % confidence interval (CI): −0.255, −0.019; P = 0.023), external elastic membrane volume (SMD: −0.097, 95 % CI: −0.183, −0.011; P = 0.027) but not lumen volume (SMD: −0.025, 95 % CI: −0.110, +0.061; P = 0.574). There was a significant reduction in fibrous plaque volume (SMD: −0.129, 95 % CI: −0.255, −0.003; P = 0.045) and an increase of dense calcium volume (SMD: +0.229, 95 % CI: +0.008, +0.450; P = 0.043), while changes in fibro-fatty (SMD: −0.247, 95 % CI: −0.592, +0.098; P = 0.16) and necrotic core (SMD: +0.011, 95 % CI: −0.144, +0.165; P = 0.892) tissue volumes were not statistically significant.

Conclusions

This meta-analysis indicates a significant effect of statin therapy on plaque and external elastic membrane volumes and fibrous and dense calcium volumes. There was no effect on lumen volume, fibro-fatty and necrotic tissue volumes.
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Metadata
Title
Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies
Authors
Maciej Banach
Corina Serban
Amirhossein Sahebkar
Dimitri P. Mikhailidis
Sorin Ursoniu
Kausik K. Ray
Jacek Rysz
Peter P. Toth
Paul Muntner
Svetlana Mosteoru
Hector M. García-García
G. Kees Hovingh
John JP Kastelein
Patrick W. Serruys
Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2015
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-015-0459-4

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