title: The effect of statin therapy on plaque regression following acute coronary syndrome: a meta-analysis of prospective trials.
abstract: OBJECTIVE
  To investigate the effect of statins on plaque regression after acute coronary syndrome (ACS).
  
  
  METHODS
  We carried out a meta-analysis to assess the change in plaque and plaque components in patients with ACS under statin therapy. This meta-analysis combined data of 1623 participants from eight randomized-controlled trials and seven observational studies.
  
  
  RESULTS
  The benefits of high-intensity statin therapy on plaque regression occurred after 6 months [standardized mean difference (SMD): -0.27; 95% confidence interval (CI): -0.43 to -0.12; P=0.0006] and were sustained over 12 months (SMD: -0.14; 95% CI: -0.25 to -0.03; P=0.01). No significant decrease was observed in the plaque volume and percent plaque volume under low-dose statin treatment. After 6 months of intensive statin treatment, the plaque volume reduced significantly in patients whose follow-up LDL cholesterol levels did (SMD: -0.16; 95% CI: -0.29 to -0.03; P=0.02) or did not (SMD: -0.21; 95% CI: -0.32 to -0.09; P=0.0007) decrease to 70 mg/dl or less. There was no significant change in plaque composition volumes, but an increase was found in the percent dense calcium volume of 1.31% (95% CI: 0.55-2.07%; P=0.0007).
  
  
  CONCLUSIONS
  Intensive statin therapy duration over 6 months may be as important as achieved LDL-C of less than or equal to 70 mg/dl in plaque regression following ACS. Intensive statin treatment may lead to an earlier regression compared with low-dose statin therapy.
authors.affiliation: aDepartment of Cardiology, the First Affiliated Hospital of Chongqing Medical University bSchool of Public Health and Health Management, Chongqing Medical University, Chongqing cDepartment of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province dDepartment of Cardiology, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shanxi Province, China.
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Tang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yang
authors.forename: Suxin
authors.initials: S
authors.lastname: Luo
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhao
authors.forename: Chunyan
authors.initials: C
authors.lastname: Lu
authors.forename: Yongbai
authors.initials: Y
authors.lastname: Luo
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.forename: Hua
authors.initials: H
authors.lastname: Xiao
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D058226:Plaque, Atherosclerotic; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors