title: Impact of Intensive LDL Cholesterol Lowering on Coronary Artery Atherosclerosis Progression: A Serial CT Angiography Study.
abstract: The aim of this study was to explore the relationship between temporal changes in coronary plaque volume and the intensity of lipid-lowering treatments, utilizing coronary computed tomography angiography (CTA).
  
  
  
  Coronary CTA has acceptable accuracy in terms of quantitative measurement of plaque volume. Although, coronary CTA is perhaps capable of identifying the differences in plaque volume progression according to the intensity of lipid lowering treatment, to date, few studies have examined this notion.
  
  
  
  In this multicenter, observational study, the authors reviewed 467 patients who underwent serial coronary CTA with a scan period of more than 2 years (median 3.2 years [2.4 to 4.8]) apart, and whose laboratory data were available within 1 month of both the baseline and follow-up coronary CTA. Among them, 147 patients (comprising 336 vessels) with visible plaque were enrolled in this study. The authors performed quantitative assessment of coronary plaque in both. Patients who achieved a low-density lipoprotein cholesterol (LDL-C) with a cut off value below 70 mg/dl at follow-up were compared with those who did not.
  
  
  
  Patients with LDL-C below 70 mg/dl displayed a significant attenuation in plaque progression as compared with those with follow-up LDL-C levels ≥70 mg/dl (12.7 ± 38.2 mm3vs. 44.2 ± 73.6 mm3, respectively; p = 0.014). In multivariate analysis, factors influencing plaque progression per year was follow-up LDL-C levels ≥70 mg/dl (beta 0.193; p = 0.021).
  
  
  
  Strict LDL-C control appeared to significantly attenuate plaque volume progression based on noninvasive quantitative assessment by coronary CTA.
authors: Division of Cardiology, Department of Internal Medicine, NHIS Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea; Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
authors: Sanghoon
authors: S
authors: Shin
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Myungji Hospital, Goyang-si, Gyeonggi-do, South Korea.
authors: Hyung-Bok
authors: HB
authors: Park
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea. Electronic address: hjchang@yuhs.ac.
authors: Hyuk-Jae
authors: HJ
authors: Chang
authors: Mayo Clinic, Division of Cardiology, Department of Internal Medicine, Scottsdale, Arizona.
authors: Reza
authors: R
authors: Arsanjani
authors: Weill Cornell Medical College and the New York-Presbyterian Hospital, New York, New York.
authors: James K
authors: JK
authors: Min
authors: Division of Cardiology, Seoul National University Hospital, Seoul, South Korea.
authors: Yong-Jin
authors: YJ
authors: Kim
authors: Division of Cardiology, Gangnam Severance Hospital, Seoul, South Korea.
authors: Byoung Kwon
authors: BK
authors: Lee
authors: Division of Cardiology, Busan Medical Center, Busan, South Korea.
authors: Jung-Hyun
authors: JH
authors: Choi
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
authors: Geu-Ru
authors: GR
authors: Hong
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
authors: Namsik
authors: N
authors: Chung
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D018450:Disease Progression; D015536:Down-Regulation; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: atherosclerosis; coronary computed tomography angiography; coronary plaque quantification; low-density lipoprotein-cholesterol