Rosuvastatin effect on atherosclerotic plaque metabolism: A subclinical atherosclerosis imaging study with 18 F-NaF PET-CT.

Autor: Oliveira-Santos M; Cardiology Department, Unidade Local de Saúde de Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal; Institute of Nuclear Sciences Applied to Health - University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal. Electronic address: oliveirasantos@uc.pt., Borges-Rosa J; Cardiology Department, Unidade Local de Saúde de Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal., Silva R; Institute of Nuclear Sciences Applied to Health - University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal., Paixão L; Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal., Santo CE; Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal., Abrunhosa A; Institute of Nuclear Sciences Applied to Health - University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal., Castelo-Branco M; Institute of Nuclear Sciences Applied to Health - University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal., Slomka PJ; Division of Artificil Inteligence in Medicine, Department of Medicine, Cedars-Sinai, Los Angeles, USA., Gonçalves L; Cardiology Department, Unidade Local de Saúde de Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal., Ferreira MJ; Cardiology Department, Unidade Local de Saúde de Coimbra, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal; Institute of Nuclear Sciences Applied to Health - University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2024 Aug; Vol. 395, pp. 117481. Date of Electronic Publication: 2024 Feb 29.
DOI: 10.1016/j.atherosclerosis.2024.117481
Abstrakt: Background and Aims: Atherosclerotic plaque fluorine-18 sodium fluoride ( 18 F-NaF) uptake on positron emission tomography with computed tomography (PET-CT) identifies active microcalcification and has been shown to correlate with clinical instability in patients with cardiovascular (CV) disease. Statin therapy promotes coronary macrocalcification over time. Our aim was to investigate rosuvastatin effect on atheroma 18 F-NaF uptake.
Methods: Subjects with high CV risk but without CV events underwent 18 F-NaF-PET-CT in a single-centre. Those with subclinical atherosclerosis and significant 18 F-NaF plaque uptake were included in a single-arm clinical trial, treated with rosuvastatin 20 mg/daily for six months, and re-evaluated by 18 F-NaF-PET-CT. Primary endpoint was reduction in maximum atheroma 18 F-NaF uptake in the coronary, aortic or carotid arteries, assessed by the tissue-to-background ratio (TBR). The secondary endpoint was corrected uptake per lesion (CUL) variation.
Results: Forty individuals were enrolled and 38 included in the pharmacological trial; mean age was 64 years, two-thirds were male and most were diabetic. The 10-year expected CV risk was 9.5% (6.0-15.3) for SCORE2 and 31.7 ± 18.7% for ASCVD systems. After six months of rosuvastatin treatment (n = 34), low-density lipoprotein cholesterol lowered from 133.6 ± 33.8 to 58.8 ± 20.7 mg dL -1 (60% relative reduction, p < 0.01). There was a significant 19% reduction in maximum plaque 18 F-NaF uptake after treatment, from 1.96 (1.78-2.22) to 1.53 (1.40-2.10), p < 0.001 (primary endpoint analysis). The secondary endpoint CUL was reduced by 23% (p = 0.003).
Conclusion: In a single-centre non-randomized clinical trial of high CV risk individuals with subclinical atherosclerosis, the maximum atherosclerotic plaque 18 F-NaF uptake was significantly reduced after six months of high-intensity statin.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: