title: The short-term effect of atorvastatin on carotid plaque morphology assessed by computer-assisted gray-scale densitometry: a pilot study.
abstract: Soft, lipid-containing carotid plaques, which appear echolucent on ultrasound imaging, have been associated with increased risk of ischemic stroke. We sought to investigate the effect of short-term treatment with atorvastatin on the change of carotid plaque echodensity. We treated 40 stroke-free and statin-naive subjects with 80 mg atorvastatin daily for 30 days. Computer assisted gray-scale densitometry (GSD) index was calculated at baseline and 30 days after treatment from the normalized plaque images. A multiple logistic regression was used to assess the effect modification of low-density lipoprotein (LDL) cholesterol on plaque stabilization after adjusting for age, sex, and smoking. The average number of carotid plaques at baseline was 2 (range: 0-5; 27 subjects with carotid plaque) and did not change 30 days following atorvastatin treatment. The mean GSD index significantly increased from 73±16 (range: 1-125) at baseline to 89±15 (range: 1-137) at 30 days after treatment (P<0.05). The adjusted odds ratio for the positive GSD plaque index change (vs. no change or decreased gray-scale median (GSM) index) was 1.71 (95% confidence interval: 1.1-7.6, P<0.01). In conclusion, we observed decreased echolucency (increased echodensity) of carotid artery plaques after short-term treatment with atorvastatin.
authors.affiliation: Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Della-Morte
authors.forename: Issam
authors.initials: I
authors.lastname: Moussa
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Elkind
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008078:Cholesterol, LDL / Q000097:blood; D003720:Densitometry / Q000379:methods; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D010865:Pilot Projects; D011758:Pyrroles / Q000627:therapeutic use*; D014463:Ultrasonography
chemical_list: D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin
references.citation: Cardiology. 2010;115(3):221-8
references.pmid: 20234134
references.citation: Neurology. 2008 Apr 1;70(14):1200-7
references.pmid: 18354078
references.citation: Radiology. 1998 Sep;208(3):649-54
references.pmid: 9722841
references.citation: Eur J Vasc Endovasc Surg. 1995 May;9(4):389-93
references.pmid: 7633982
references.citation: Drugs Today (Barc). 2010 Aug;46(8):601-8
references.pmid: 20830320
references.citation: Eur J Vasc Endovasc Surg. 1996 May;11(4):414-6
references.pmid: 8846173
references.citation: JAMA. 2001 May 16;285(19):2486-97
references.pmid: 11368702
references.citation: Stroke. 2011 Dec;42(12):3460-4
references.pmid: 21903964
references.citation: Eur J Vasc Endovasc Surg. 2008 Jun;35(6):661-8
references.pmid: 18395477
references.citation: Ultrasound Med Biol. 2009 Nov;35(11):1763-72
references.pmid: 19647921
references.citation: BMC Cardiovasc Disord. 2009 Dec 22;9:55
references.pmid: 20028534
references.citation: Atherosclerosis. 2011 Feb;214(2):295-300
references.pmid: 21130458
references.citation: J Vasc Surg. 2010 Jan;51(1):114-21
references.pmid: 19837545
references.citation: NMR Biomed. 2011 Jan;24(1):89-95
references.pmid: 21259368
references.citation: Circulation. 2003 Apr 29;107(16):2072-5
references.pmid: 12719287
references.citation: Circulation. 2004 Aug 10;110(6):756-62
references.pmid: 15277320
references.citation: Neurology. 2009 Feb 24;72(8):688-94
references.pmid: 18768917