Effect of Statin Therapy on Fibrous Cap Thickness in Coronary Plaques Using Optical Coherence Tomography: A Systematic Review and Meta-Analysis.
OBJECTIVE
We conducted a systematic review and meta-analysis to evaluate the effect of statin therapy on coronary fibrous cap thickness (FCT) as assessed by optical coherence tomography (OCT) and the relationship between FCT and traditional coronary risk factors.


BACKGROUND
Increasing evidence has shown that statin therapy results in a marked increase in coronary FCT. However, the relationship between this increase in FCT and the lipid profile has not been clearly elucidated.


METHODS
A literature search of PubMed, Embase, the Cochrane Library, and Web of Science up to March 17, 2015 was performed. Studies providing data on FCT using OCT at baseline and follow-up in patients receiving statin therapy were included. Weighted mean difference (WMD) with a random-effects model was used.


RESULTS
Six OCT studies were included. The FCT in coronary plaques was significantly increased after statin therapy (WMD: 58.79 μm, 95% CI 33.82-83.76 μm, P < 0.001). When compared with the placebo group, the increase in FCT was also greater in the statin group (WMD: 72.28 μm, 95% CI 44.97-99.58 μm, P < 0.001). Meta regression analysis demonstrated no significant correlations between the increase in FTC and the changes in total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels during follow-up. Similarly, there were no significant correlations between the increase in FCT and age, male gender, hypertension, diabetes, and smoking.


CONCLUSIONS
Statin therapy induced a significant increase in coronary FCT evaluated by OCT. This increase in FCT was independent of traditional coronary risk factors including the lipid profile.
Department of Cardiology, Zhangzhou Hospital Affiliated to Fujian Medical University, Fujian, China.|First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
Guian
G
Zheng
Department of Cardiology, Zhangzhou Hospital Affiliated to Fujian Medical University, Fujian, China.
Jiandong
J
Chen
Department of Cardiology, Zhangzhou Hospital Affiliated to Fujian Medical University, Fujian, China.
Chunyi
C
Lin
Department of Cardiology, Zhangzhou Hospital Affiliated to Fujian Medical University, Fujian, China.
Xiaohong
X
Huang
First Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.|Department of Cardiology, First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
Jinxiu
J
Lin
D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000188:drug therapy*; D041623:Tomography, Optical Coherence
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors