Meta-Analysis Comparing the Effect of Combined Omega-3 + Statin Therapy Versus Statin Therapy Alone on Coronary Artery Plaques

Autor: Heze Fan, Juan Zhou, Zuyi Yuan
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Computed Tomography Angiography
Coronary Artery Disease
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Randomized controlled trial
law
Internal medicine
Intravascular ultrasound
Fatty Acids
Omega-3
medicine
Humans
030212 general & internal medicine
Ultrasonography
Interventional
Randomized Controlled Trials as Topic
medicine.diagnostic_test
Cholesterol
business.industry
Fibrous cap
Cholesterol
HDL
Cholesterol
LDL
Confidence interval
Plaque
Atherosclerotic
medicine.anatomical_structure
C-Reactive Protein
Treatment Outcome
chemistry
Strictly standardized mean difference
Meta-analysis
Cardiology
Drug Therapy
Combination
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiology and Cardiovascular Medicine
business
Tomography
Optical Coherence
Artery
Zdroj: The American journal of cardiology. 151
ISSN: 1879-1913
Popis: Statin therapy plays an important role in stabilizing and regressing coronary artery plaques. Omega-3 supplements also have anti-inflammatory and antioxidant effects on coronary plaques. However, the effect of omega-3 supplementation on the basis of statin therapy on the stability and composition of plaques, is still unclear. We searched for randomized controlled trials published prior to November 2020 in the PubMed, Embase and Cochrane databases. Finally, eight studies using different imaging techniques to evaluate coronary atherosclerotic plaque, including optical coherence tomography (OCT), coronary CT angiography (cCTA) and intravascular ultrasound (IB-IVUS), met our inclusion criteria. We pooled data extracted from the included studies using the standardized mean difference (SMD) or mean difference (MD) of the random effects model. Compared with statin treatment alone, the combined treatment further delayed the progression of total plaque volume [SMD -0.36, 95% confidence interval (CI) -0.64 to -0.08, p = 0.01] and fiber content (SMD -0.40, 95% CI -0.68 to -0.13, p = 0.004). The plasma high-sensitivity C-reactive protein (hs-CRP) level of patients in the combination treatment group was significantly lower than that of the patients in the statin treatment group alone (SMD -0.30, 95% CI -0.59 to -0.01, p = 0.04). In addition, the combined use of omega-3 further increases the fibrous cap thickness (FCT) of the plaque with an MD of 29.45 μm. There were no significant differences in plasma high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), or lipid content in plaques between the two groups. Omega-3 combined with statins is superior to the statin treatment group in stabilizing and promoting coronary plaque regression and may help to further reduce the occurrence of cardiovascular events.
Databáze: OpenAIRE
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