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dc.contributor.authorSingh, Parmananden
dc.contributor.authorEmami, Hameden
dc.contributor.authorSubramanian, Sharathen
dc.contributor.authorMaurovich-Horvat, Palen
dc.contributor.authorMarincheva-Savcheva, Gerganaen
dc.contributor.authorMedina, Hector Men
dc.contributor.authorAbdelbaky, Amren
dc.contributor.authorAlon, Achillesen
dc.contributor.authorShankar, Sudha Sen
dc.contributor.authorRudd, Jamesen
dc.contributor.authorFayad, Zahi Aen
dc.contributor.authorHoffmann, Udoen
dc.contributor.authorTawakol, Ahmeden
dc.date.accessioned2016-12-06T10:04:17Z
dc.date.available2016-12-06T10:04:17Z
dc.date.issued2016-12en
dc.identifier.issn1941-9651
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/261449
dc.description.abstract$\textbf{Background:}$ Non-obstructive coronary plaques manifesting higher-risk morphology (HRM) associate with an increased risk of adverse clinical cardiovascular events. We sought to test the hypothesis that statins have a greater anti-inflammatory effect within coronary plaques containing HRM. $\textbf{Methods:}$ In this prospective multicenter study, 55 subjects with or at high risk for atherosclerosis underwent $^{18}$F-fluorodeoxyglucose-positron emission tomography/ computed tomography (FDG-PET/CT) imaging at baseline and after 12 weeks of treatment with atorvastatin. Coronary arterial inflammation (FDG uptake, expressed as target-to-background ratio [TBR]) was assessed in the left main coronary artery (LMCA). While blinded to the PET findings, contrast-enhanced CT angiography (CTA) was performed to characterize the presence of HRM (defined as non-calcified or partially-calcified plaques) in the LMCA. $\textbf{Results:}$ Arterial inflammation (TBR) was higher in LMCA segments with- vs. without- HRM (mean ± SEM: 1.95±0.43 vs. 1.67±0.32, LMCA with- vs. without HRM, p=0.04). Moreover, atorvastatin treatment for 12 weeks reduced TBR more in LMCA segments with- vs without-HRM (12 week-baseline ΔTBR [95% CI]: -0.18 [-0.35, -0.004] vs. 0.09 [-0.06, 0.26], p=0.02). Furthermore, this relationship between coronary plaque morphology and change in LMCA inflammatory activity remained significant after adjusting for baseline LDL and statin dose ($\beta$=-0.27, p=0.038). $\textbf{Conclusions:}$ In this first study to evaluate the impact of statins on coronary inflammation, we observed that the anti-inflammatory impact of statins is substantially greater within coronary plaques that contain higher-risk morphological features. These findings suggest an additional mechanism by which statins disproportionately benefit individuals with more advanced atherosclerotic disease.
dc.description.sponsorshipNational Heart, Lung, and Blood Institute of the National Institutes of Health (5T32 HL076136) and Marfan Foundation, National Institute for Health Research Cambridge Biomedical Research Centre, British Heart Foundation, Wellcome Trust
dc.format.mediumPrinten
dc.languageengen
dc.language.isoenen
dc.publisherAmerican Heart Association
dc.rightsAttribution 4.0 Internationalen
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectCoronary Vesselsen
dc.subjectHumansen
dc.subjectFluorodeoxyglucose F18en
dc.subjectAnti-Inflammatory Agentsen
dc.subjectInflammation Mediatorsen
dc.subjectRadiopharmaceuticalsen
dc.subjectCoronary Angiographyen
dc.subjectTreatment Outcomeen
dc.subjectSeverity of Illness Indexen
dc.subjectRisk Factorsen
dc.subjectProspective Studiesen
dc.subjectDouble-Blind Methoden
dc.subjectPredictive Value of Testsen
dc.subjectTime Factorsen
dc.subjectAdulten
dc.subjectAgeden
dc.subjectMiddle Ageden
dc.subjectUnited Statesen
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectCoronary Artery Diseaseen
dc.subjectPlaque, Atheroscleroticen
dc.subjectVascular Calcificationen
dc.subjectBiomarkersen
dc.subjectAtorvastatin Calciumen
dc.subjectComputed Tomography Angiographyen
dc.subjectPositron Emission Tomography Computed Tomographyen
dc.titleCoronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study.en
dc.typeArticle
prism.publicationDate2016en
prism.publicationNameCirculation. Cardiovascular imagingen
prism.volume9en
dc.identifier.doi10.17863/CAM.6637
dcterms.dateAccepted2016-09-29en
rioxxterms.versionAMen
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/en
rioxxterms.licenseref.startdate2016-12en
dc.contributor.orcidRudd, James [0000-0003-2243-3117]
dc.identifier.eissn1942-0080
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idBritish Heart Foundation (PG/09/083/27667)
pubs.funder-project-idBritish Heart Foundation (FS/12/29/29463)
rioxxterms.freetoread.startdate2100-01-01


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International