title: Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment.
abstract: This study aimed to determine the relationship of statin therapy and cardiovascular risk factors to changes in atherosclerosis in the carotid artery.
  
  
  
  Carotid magnetic resonance imaging was used to evaluate 106 hyperlipidemic participants at baseline and after 12 months of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) treatment. Multivariable logistic regression was used to determine factors associated with progression (change in carotid wall volume >0) or regression (change ≤0) of carotid atherosclerosis. Computed tomography coronary calcium scores were obtained at baseline for all participants. The median age was 65 years (interquartile range 60-69 years), and 63% of the participants were male. Body mass index >30, elevated C-reactive protein, and hypertension were associated with increased carotid wall volume (obesity: odds ratio for progression 4.6, 95% CI 1.8-12.4, P<0.01; C-reactive protein: odds ratio for progression 2.56, 95% CI 1.17-5.73, P=0.02; hypertension: odds ratio 2.4, 95% CI 1.1-5.3, P<0.05). Higher statin dose was associated with regression of carotid wall volume (P<0.05). In multivariable analysis, obesity remained associated with progression (P<0.01), whereas statin use remained associated with regression (P<0.05). Change in atheroma volume in obese participants was +4.8% versus -4.2% in nonobese participants (P<0.05) despite greater low-density lipoprotein cholesterol reduction in obese participants.
  
  
  
  In a population with hyperlipidemia, obese patients showed atheroma progression despite optimized statin therapy.
  
  
  
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01212900.
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD.
authors.forename: Veit
authors.initials: V
authors.lastname: Sandfort
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Shenghan
authors.initials: S
authors.lastname: Lai
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ahlman
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD.
authors.forename: Marissa
authors.initials: M
authors.lastname: Mallek
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD.
authors.forename: Songtao
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Sibley
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD.
authors.forename: Evrim B
authors.initials: EB
authors.lastname: Turkbey
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: João A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD bluemked@cc.nih.gov.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D018450:Disease Progression; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: carotid artery; carotid magnetic resonance imaging; obesity