title: Ultrasound assessment of carotid plaque echogenicity response to statin therapy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate in a systematic review and meta-analysis model the effect of statin therapy on carotid plaque echogenicity assessed by ultrasound.
  
  
  METHODS
  We have systematically searched electronic databases (PubMed, MEDLINE, EMBASE and Cochrane Center Register) up to April, 2015, for studies evaluating the effect of statins on plaque echogenicity. Two researchers independently determined the eligibility of studies evaluating the effect of statin therapy on carotid plaque echogenicity that used ultrasound and grey scale median (GSM) or integrated back scatter (IBS).
  
  
  RESULTS
  Nine out of 580 identified studies including 566 patients' carotid artery data were meta-analyzed for a mean follow up of 7.2 months. A consistent increase in the echogenicity of carotid artery plaques, after statin therapy, was reported. Pooled weighted mean difference % (WMD) on plaque echogenicity after statin therapy was 29% (95% CI 22%-36%), p<0.001, I2=92.1%. In a meta-regression analysis using % mean changes of LDL, HDL and hsCRP as moderators, it was shown that the effects of statins on plaque echogenicity were related to changes in hsCRP, but not to LDL and HDL changes from the baseline. The effect of statins on the plaque was progressive; it showed significance after the first month of treatment, and the echogenicity continued to increase in the following six and 12 months.
  
  
  CONCLUSIONS
  Statin therapy is associated with a favorable increase of carotid plaque echogenicity. This effect seems to be dependent on the period of treatment and hsCRP change from the baseline, independent of changes in LDL and HDL.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden. pranvera.ibrahimi@medicin.umu.se.
authors.forename: Pranvera
authors.initials: P
authors.lastname: Ibrahimi
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden. fisnik.jashari@medicin.umu.se.
authors.forename: Fisnik
authors.initials: F
authors.lastname: Jashari
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden. ganibajraktari@yahoo.co.uk.
authors.forename: Gani
authors.initials: G
authors.lastname: Bajraktari
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden. per.wester@medicin.umu.se.
authors.forename: Per
authors.initials: P
authors.lastname: Wester
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden. michael.henein@medicin.umu.se.
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Henein
mesh_terms: D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy; D017594:Publication Bias; D012044:Regression Analysis; D014465:Ultrasonics; D014463:Ultrasonography
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: carotid atherosclerosis; plaque echogenicity; statins; ultrasound