In. Any dosage of statins was associated with a higher presence of calcification, whilst only high dosages (DDD > 1.33) were associated with a lower presence of lipid core. 2015;39(5-6):319-24. doi: 10.1159/000381138. ribeye steak), liver, and egg yolks. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Mayo Clinic does not endorse any of the third party products and services advertised. Information for the duration and dosage of statin use was obtained from pharmacy records for all participants. Arps K, Al Rifai M, Blaha MJ, et al. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. There is now overwhelming evidence to support reducing LDL-c (low-density lipoprotein cholesterol) to reduce atherosclerotic cardiovascular disease (CVD). https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm293330.htm. The Role of Inflammation in Cardiovascular Disease. Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins, Novel Agents, Primary Hyperlipidemia, Statins, Keywords: Dyslipidemias, Calcium, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiovascular Diseases, Coronary Vessels, Hyperlipoproteinemia Type II, Secondary Prevention, Research Design, Reference Values, Prognosis, Retrospective Studies, Follow-Up Studies, Area Under Curve, Coronary Disease, Risk Factors, Risk Assessment, Diabetes Mellitus, Diabetes Mellitus, Risk Reduction Behavior, Chest Pain, Atherosclerosis, Cardiology, Reference Standards, Acceleration, Aspirin, Lipids, Resource Allocation. Henein MY, Vancheri S, Longo G, Vancheri F. Int J Mol Sci. Coronary calcium score and cardiovascular risk. Would you like email updates of new search results? Objectives: JAMA Cardiol 2021;6:1257-66. [Evaluation of carotid atherosclerotic plaques by vascular plaque quantification (VPQ) technology of three-dimensional ultrasonography]. Evaluation of newer risk markers for coronary heart disease risk classification: a cohort study. van Rosendael reports grant support from the National Research Foundation of Korea and ICT. If your LDL cholesterol is lowered below 70 mg/dL, you can even see a regression in the plaque by up to 24%. Eur Heart J. There was a statistically significant interaction by baseline statin use, resulting in weaker associations between Agatston CAC scores and both outcomes. We do not endorse non-Cleveland Clinic products or services. In the statin-treated group, LDL-cholesterol levels were slightly lower than in the untreated group at baseline (107 vs 113 mg/dL; P = 0.03) but markedly lower in follow-up (88 vs 110 mg/dL; P < 0.001). This present analysis supports findings from the above literature, i.e., suggesting a role of statin therapy in accelerating plaque transformation from noncalcified to calcified content and thus aiding plaque stabilization. 2018;12:757. The food containing the highest amount of Vitamin K2 is a highly fermented soy food called natto, which very few people can tolerate given its strong odor and flavor. What is evident in the statin-treated patients, said lead investigator Alexander van Rosendael, MD (Leiden University Medical Center, the Netherlands), is a more-rapid transformation of soft plaque into the very dense calcium and a lower progression of coronary plaque with increasing density. MeSH These patients had suspected or known CAD and underwent serial CCTA 2 or more years apart between 2013 to 2016 across seven countries; 857 patients were included in this analysis. HHS Vulnerability Disclosure, Help Cholesterol ratio or non-HDL cholesterol: Which is most important? Epub 2019 Feb 10. Epub 2018 Aug 30. Type 2 diabetes or high blood sugar. High cholesterol treatment: Does cinnamon lower cholesterol? An official website of the United States government. Association of high-density calcified 1K plaque with risk of acute coronary syndrome. It was unclear, however, whether the associations with events would be as strong as those in statin-nave populations. The population of statin users with high CAC scores therefore encompasses very high-risk individuals and individuals with highly stable plaques at relatively lower risk of events. PMC health information, we will treat all of that information as protected health You wouldn't need any additional liver enzyme tests unless you begin to have signs or symptoms of trouble with your liver. 2019;26:e000. Higher calcium density is associated with slowed plaque progression. Plaque, Atherosclerotic . 2015 Nov 15;116(10):1521-6. doi: 10.1016/j.amjcard.2015.08.010 . On the other hand, there was a bit of a seesaw effect seen in the statin-treated patients, whereby the decreases in low-attenuation and fibro-fatty plaque were offset by increases in high-density and 1K plaque. The ability to study the progression of plaque and the specific effects on the composition of atherosclerotic plaques with various therapies, specifically statin therapy in CCTA PARADIGM, may further increase the utility of CCTA in the management of coronary artery disease. Association between Adipose Tissue Depots and Dyslipidemia: The KORA-MRI Population-Based Study. A key mechanism underlying this phenomenon is that statins increase plaque density thereby paradoxically raising the Agatston CAC scoreas density is upweighted. Increasing plaque calcium density was associated with lower proportion of low-attenuation plaque, fibro-fatty plaque, and fibrous plaque. Unable to load your collection due to an error, Unable to load your delegates due to an error. Statin therapy is associated with alteration in coronary plaque features, namely higher calcium density and lower low-attenuation and fibro-fatty plaque volumes. . On the flip side, van Rosendael previously showed that the presence of very dense coronary plaque, dubbed 1K plaque (> 1,000 Hounsfield units), was associated with a lower risk of ACS. Achenbach S, Ropers D, Pohle K, et al. Those who were treated were older, more commonly male, and more likely to have diabetes and hypertension. Statin drugs have been shown to reduce serum cholesterol along with significant reduction in morbidity and mortality of cardiovascular disease. For most people, the answer is a resounding yes, according to a 2014 Johns Hopkins meta-analysis of 20 years worth of published research. Calcium density of coronary artery plaque and risk of incident cardiovascular events. MeSH Grundy SM, Stone NJ, Bailey AL, et al. . Is there a risk of rhabdomyolysis from statins? Rarely, if the increase is severe, you may need to try a different statin. Artificial Sweetener Erythritols Major Health Risks, Best Ingredients and Products for Your Anti-Aging Skin Care Routine. Doctors often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke. Criqui MH, Denenberg JO, Ix JH, et al. Mszar R, Nasir K, Santos RD. Impact of statins on serial coronary calcification during atheroma progression and regression. Retrospective cohort analysis using data from the CAC Consortium focused on subjects with information on baseline statin use (n=28,025), with a mean follow-up of 11 years. Keywords: Disclaimer. These drugs further stabilize atherosclerotic plaque with thickened fibrous caps and macrocalcification that serves to stabilize atheromas. Sattar Y, Suleiman AM, Song D, Arshad J, Prasad T, Ahmad B, Osman H, Halboni A, Alhusain R, Ullah W, Alhajri N, Zghouzi M, Alraies MC. The site is secure. Peng AW, Mirbolouk M, Orimoloye OA, et al. Adhyaru BB, et al. Cox regression models were used to evaluate the associations between CAC scores with incident cardiac events controlling for traditional risk factors. Don't stop taking your statin medication before talking to your doctor. Of these, 171,189 (13.7%) had at least 1 reported SASE since year 2000. Beijing Da Xue Xue Bao Yi Xue Ban. Coronary artery calcium for personalized allocation of aspirin in primary prevention of cardiovascular disease in 2019: The MESA Study (Multi-Ethnic Study of Atherosclerosis). Study limitations include the observational study design, lack of statin dosing information, and potential selection bias. Methods and Findings. JACC Cardiovasc Imaging. Lopez-Jimenez F (expert opinion). aimed at assessing the prognostic utility of CAC for predicting risk of coronary heart disease (CHD) and CVD events comparing non-users and users of statins at the time of the CAC scan.17. 2018;39:2526. The increase generally occurs when blood sugar levels are already higher than normal and fall in the prediabetes or diabetes range when you begin taking a statin. Accessed Jan. 29, 2019. This data supports results previously reported in the ICONIC study, which showed that coronary plaque in patients with acute coronary syndrome had larger volume of noncalcified components, possibly reflecting an earlier, more active stage of atherosclerosis.5 Conversely, data from MESA and ICONIC revealed higher plaque calcium density in patients with lower risk of cardiac events.3,4 It is conceivable that the presence of high-density calcium sheets implies that plaque naturally progressed to a more stable form. HHS Vulnerability Disclosure, Help Association Between Serum Uric Acid and Carotid Intima-Media Thickness in Different Fasting Blood Glucose Patterns: A Case-Control Study. Benefits of Statin Therapy. van Rosendael AR, van den Hoogen IJ, Gianni U, et al. Active, high-dosage statin use seems to beneficially influence the composition of carotid atherosclerosis by shifting the composition from vulnerable plaque with a lipid core to more stable calcified plaque. Selwaness M, Bos D, van den Bouwhuijsen Q, Portegies ML, Ikram MA, Hofman A, Franco OH, van der Lugt A, Wentzel JJ, Vernooij MW. Effects of statins on coronary atherosclerotic plaques: the PARADIGM Study. As it becomes denser and denser, this type of plaque carries less risk, said van Rosendael. Copyright 2018 Elsevier B.V. All rights reserved. Nevertheless, the direct effects of statin treatment on the composition of atherosclerotic plaques remain elusive. This study confirmed the notion of statin therapy as a key intervention in stabilization atherosclerotic disease. Cainzos-Achirica M, Agrawal T. Implications of the plaque density paradox for risk assessment in 2020. Very rarely, statins can cause life-threatening muscle damage called rhabdomyolysis (rab-doe-my-OL-ih-sis). Using fixed Hounsfield units, coronary lesions were categorized by plaque volumes and calcium composition as low-attenuation plaque, fibro-fatty plaque, fibrous plaque, low-density calcium, high-density calcium, and very densely calcified 1K plaque. Lipid lowering effect. Shemesh J, Apter S, Itzchak Y, Motro M. Coronary calcification compared in patients with acute versus in those with chronic coronary events by using dual-sector spiral CT. Henein M, Gransen G, Wiklund U, et al. The association between CAC and outcomes in statin users was significantly attenuated compared to those in nonusers, however, the improvement in predictive value compared to risk factor models alone was similar in both groups. Epub 2022 Jun 23. other information we have about you. While statins are highly effective and safe for most people, they have been linked to muscle pain, digestive problems and mental fuzziness in some people who take them and may rarely cause liver damage. 2022 Feb 14;14(4):797. doi: 10.3390/nu14040797. Hypothyroidism: Should I take iodine supplements? 2018 Nov 15;271:24. doi: 10.1016/j.ijcard.2018.04.107. Increasing knowledge of the atherosclerotic process, as well as atherosclerotic plaque composition and morphology, has lead to the identification of vulnerable plaques that lead to acute coronary syndromes. Drug-induced diabetes mellitus: Evidence for statins and other drugs affecting glucose metabolism. Past studies have shown that the burden of atherosclerosis in the coronary tree is a strong predictor of future coronary events, said van Rosendael, but refining the risks associated with different components of coronary plaque is currently an important area of research. Motoyama S, Ito H, Sarai M, et al. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018. Coronary artery disease (CAD) is highly prevalent and if inadequately treated can often lead to major adverse cardiovascular events (MACE).1 Treatment begins with aggressive lifestyle and behavioral modifications, but often requires pharmacologic therapy with statin therapy for appropriate risk factor control in those with elevated atherosclerotic cardiovascular disease (ASCVD) risk. In the placebo group (placebo + statin), patients achieved an average LDL-c level of 74.4 mg/dL (1.9 mmol/L) at week 52 (reduction of 50.7% compared to baseline). About cholesterol. Coronary artery calcification in familial hypercholesterolemia: an opportunity for risk assessment and shared decision making with the power of zero? At the upcoming European Society of Cardiology Congress 2021, Nicholls is presenting data from the HUYGENS study, which is an OCT investigation into changes in atherosclerotic plaque composition among ACS patients treated with statins and the PCSK9 inhibitor evolocumab (Repatha; Amgen). Which statins are most hydrophilic and are least associated with SE? astatin on plaque regression in untreated intermediate coro-nary stenosis in Korean patients. Arcus senilis: A sign of high cholesterol? People with. Stay up-to-date with breaking news, conference slides, and topical videos covering the spectrum of CVD. Al'Aref SJ, Su A, Gransar H, van Rosendael AR, Rizvi A, Berman DS, Callister TQ, DeLago A, Hadamitzky M, Hausleiter J, Al-Mallah MH, Budoff MJ, Kaufmann PA, Raff GL, Chinnaiyan K, Cademartiri F, Maffei E, Villines TC, Kim YJ, Leipsic J, Feuchtner G, Pontone G, Andreini D, Marques H, de Arajo Gonalves P, Rubinshtein R, Achenbach S, Chang HJ, Chow BJW, Cury R, Lu Y, Bax JJ, Jones EC, Pea JM, Shaw LJ, Min JK, Lin FY. Shoppers are likely to be reassured by trusted brands, or by products that have historically had a prescribed POM-V . Inclusion of CAC volume improved CVD/CHD prediction significantly while calcium density provided minimal additional predictive value in statin users. Using these modalities, it was noted that statin therapy is associated with a decrease in lipid-rich plaque and an increase in calcification. Due to this small change in plaque volume, other effects of statin therapy on plaques have been proposed . Migrino RQ, Bowers M, Harmann L, Prost R, LaDisa JF Jr. J Cardiovasc Magn Reson. If its 90% dense calcium, for example, it doesnt progress on the next CT scan. the unsubscribe link in the e-mail. Epub 2018 Aug 7. Arnett DK, Blumenthal RS, Albert MA, et al. For patients undergoing CAC screening, the new data can help refine how best to assess patient risk. 2023 American College of Cardiology Foundation. The findings confirm that CAC does have prognostic value among statin users, although the association is attenuated. The new study, which was published last week in. Statin intolerance. Talk to your doctor to see if a change of dosage or even a different type of medication might be helpful. So having really a low LDL cholesterol level can help stabilize any plaque buildup you have, and prevent further plaque progression. Nicholls said there is now evidence showing that a number of plaque characteristics on imaging, such as low-attenuation plaques on CTA, lipid burden on near-infrared spectroscopy (NIRS), and fibrous cap thickness and the presence of lipid-rich plaques on optical coherence tomography (OCT), are all associated with adverse outcomes. It extends the observations made with IVUS, but we never had the ability to look at calcium in the way that CT can and that is an important advance.. We aimed to investigate the association of statin treatment with the presence of different plaque components located in the carotid arteries within a population-based setting. Stabilize any plaque buildup you have, and fibrous plaque for your Anti-Aging Skin Care Routine updates new... Paradoxically raising the Agatston CAC scores with incident cardiac events controlling for traditional risk.! Evidence for statins and other drugs affecting Glucose metabolism J Cardiovasc Magn Reson stop taking your medication. 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