title: Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies.
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.
authors.affiliation: Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland. maciejbanach@aol.co.uk.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
authors.affiliation: Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. dr.corinaserban@yahoo.com.
authors.forename: Corina
authors.initials: C
authors.lastname: Serban
authors.affiliation: Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. amir_saheb2000@yahoo.com.|Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia. amir_saheb2000@yahoo.com.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Sahebkar
authors.affiliation: Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, UK. mikhailidis@aol.com.
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.affiliation: Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. sursoniu@yahoo.com.
authors.forename: Sorin
authors.initials: S
authors.lastname: Ursoniu
authors.affiliation: School of Public Health, Imperial College London, London, UK. koshray@gmail.com.
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authors.initials: KK
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authors.affiliation: Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland. jacek.rysz@umed.lodz.pl.
authors.forename: Jacek
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authors.lastname: Rysz
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authors.forename: Peter P
authors.initials: PP
authors.lastname: Toth
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. pmuntner@uab.edu.
authors.forename: Paul
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authors.lastname: Muntner
authors.affiliation: Institute for Cardiovascular Medicine Timisoara, Cardiology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. tanaliliana@yahoo.co.uk.
authors.forename: Svetlana
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authors.lastname: Mosteoru
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Centre, Rotterdam, The Netherlands. hgarcia@cardialysis.nl.|Cardialysis BV, Rotterdam, The Netherlands. hgarcia@cardialysis.nl.
authors.forename: Hector M
authors.initials: HM
authors.lastname: García-García
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. g.k.hovingh@amc.uva.nl.
authors.forename: G Kees
authors.initials: GK
authors.lastname: Hovingh
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. j.j.kastelein@amc.uva.nl.
authors.forename: John J P
authors.initials: JJ
authors.lastname: Kastelein
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Centre, Rotterdam, The Netherlands. patrick.w.j.c.serruys@gmail.com.|Imperial College, London, UK. patrick.w.j.c.serruys@gmail.com.
authors.forename: Patrick W
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mesh_terms: D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors