"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. Study limitations include the observational study design, lack of statin dosing information, and potential selection bias. Pathologically, free calcium is released from dying macrophages and smooth muscle cells crystalize into microcalcifications in the deeper necrotic core, and later coalesce and form denser calcium sheets.8. Banach M, Serban C, Sahebkar A, et al. 3 Statins are the most widely prescribed and evidence-based lipid-lowering drug in the world for lowering LDL-c and reducing cardiovascular morbidity and mortality, both in primary and secondary prevention. If you have read about the potential side effects of statins, you may be more likely to blame your symptoms on the medication, whether or not they're truly caused by the drug. 2022 May 27;13:899241. doi: 10.3389/fendo.2022.899241. There is a problem with Inclusion of CAC volume improved CVD/CHD prediction significantly while calcium density provided minimal additional predictive value in statin users. 2021 Mar 21;117(4):1070-1077. doi: 10.1093/cvr/cvaa184. The latter subgroup adds "noise" to the association, taking HRs closer to the null value. Accessed Jan. 29, 2019. Before For example, low-attenuation plaque is associated with higher risk of acute coronary syndromes,5-7 whereas higher-density calcium and very dense calcium (1K) are associated with lower rates of major events for a specific plaque.3,4. 2019;26:e000. Careers. Epub 2019 May 3. Journal of Atherosclerosis and Thrombosis. PMC Association of statin treatment with progression of coronary atherosclerotic plaque composition. Those who were treated were older, more commonly male, and more likely to have diabetes and hypertension. Atherosclerosis refers to the buildup of plaque in the arteries that are normally responsible for carrying blood to various vital organs of the body. The aim of the present study was to compare the effects of statin /ezetimibe combination therapy and statin monotherapy on carotid atherosclerotic plaque inflammation using 18 F-fluorodeoxyglucose (18 FDG . Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. 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. 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. Advances in cardiac imaging, from intravascular ultrasound to multi-detector coronary computed tomography angiography, have furthered our understanding of statin's effect on atherosclerotic plaque. Whats the Difference Between Good and Bad Cholesterol? and transmitted securely. Please enable it to take advantage of the complete set of features! An official website of the United States government. Accessibility Unable to load your collection due to an error, Unable to load your delegates due to an error. Cholesterol medications: Consider the options. Enter the email you used to register to reset your password. Statin muscle-related adverse events. Discuss these steps with your doctor before trying them: Although side effects believed to be caused by statins can be annoying, consider the benefits of taking a statin before you decide to stop taking your medication. Safety and efficacy of statin therapy. Clinical studies using ultrasound in the coronary arteries have shown that when you are on high doses of these medicines, even if you have plaque buildup already, you can stabilize the plaque on statin therapy. The associations are attenuated compared to those seen among statin-nave patients; however, a CAC score provides similar risk prediction in conjunction with risk factor models regardless of statin use status. Results: Mszar R, Nasir K, Santos RD. In patients not on a statin, low-attenuation and fibro-fatty plaque volumes increased over time. 2018;39:2526. 2022;80(9):880-890. doi: 10.33963/KP.a2022.0155. Effect of icosapent ethyl on progression of coronary atherosclerosis in patients with elevated triglycerides on statin therapy: a prospective, placebo-controlled randomized trial (EVAPORATE): interim results. In SCOT-HEART, low-attenuation plaque was a better predictor of future events than other commonly used measures, such as a cardiovascular risk score, coronary artery calcium (CAC), Agatston units, and presence of obstructive coronary artery disease. 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. A case of prominent coronary plaque regression with statin therapy. The statistical model was adjusted for age, sex, diabetes, hypertension, smoking status, body mass index, and the CT interval. The new study, which was published last week in. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Mach F, et al. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies. Hypothyroidism: Can calcium supplements interfere with treatment? To better understand the changes associated with statin therapy on certain plaque subtypes, the authors enrolled 2,252 patients from the CCTA PARADIGM study. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Advertising on our site helps support our mission. Atherosclerosis; Carotid artery; Epidemiology; MRI; Plaque composition; Statin. Because the condition affects every artery, if . Int J Cardiol. Objectives: Statin side effects Weigh the benefits and risks, Advertising and sponsorship opportunities, Taking multiple medications to lower your cholesterol, Having certain conditions such as hypothyroidism or neuromuscular disorders including amyotrophic lateral sclerosis (ALS), Amiodarone (Cordarone, Pacerone), a medication for irregular heart rhythms, Gemfibrozil (Lopid), another variety of cholesterol drug, HIV treatments called protease inhibitors such as saquinavir (Invirase) and ritonavir (Norvir), Some antibiotic and antifungal medications, such as clarithromycin and itraconazole (Onmel, Sporanox), Some immunosuppressant medications, such as cyclosporine (Gengraf, Neoral, Sandimmune). Shoppers are likely to be reassured by trusted brands, or by products that have historically had a prescribed POM-V . Most people don't have side effects from statins, but you shouldn't take them if you're pregnant, nursing or . Adverse effects of statin therapy: Perception vs. the evidence focus on glucose homeostasis, cognitive, renal and hepatic function, haemorrhagic stroke and cataract. The findings confirm that CAC does have prognostic value among statin users, although the association is attenuated. 2021;Epub ahead of print. Rhabdomyolysis can occur when you take statins in combination with certain drugs or if you take a high dose of statins. Uddin SMI, Mirbolouk M, Kianoush S, et al. It remains uncertain whether statin /ezetimibe combination therapy serves as a useful and equivalent alternative to statin monotherapy for reducing atherosclerotic plaque inflammation. Please enable it to take advantage of the complete set of features! On the flip side, van Rosendael previously showed that the presence of very dense coronary plaque. Association between Adipose Tissue Depots and Dyslipidemia: The KORA-MRI Population-Based Study. Specifically, statin therapy is associated with a decrease in low-attenuation and fibro-fatty plaque volumes and an increase in high-density and 1K volumes. 2022 Feb 14;14(4):797. doi: 10.3390/nu14040797. Clinical classification of plaque morphology in coronary disease. You may opt-out of email communications at any time by clicking on Virtual Screening of Novel 24-Dehydroxysterol Reductase (. In statins users, both the CAC Agatston score and CAC volume had prognostic utility for CHD and CVD risk, suggesting that CAC burden also predicts CHD and CVD risk in this group. Coronary CTA has improved clinicians' ability to treat patients with coronary artery disease. Notably, statins play a role in plaque regression with reduction in lipid content. The relevance of the mild increase in sugar values with statins observed in some people is unclear. Statin therapy in patients with atherosclerotic cardiovascular disease (ASCVD) is associated with positive changes in the phenotype of coronary lesions, with data from a new study showing there is a shift towards more-stable, calcified lesions and less higher-risk plaque. TCTMD All rights reserved. Even if your side effects are frustrating, don't stop taking your statin medication for any period of time without talking to your doctor first. PROSPECT II/ABSORB, EVAPORATE: Icosapent Ethyl May Slow Atherosclerosis Progression, New Chronic Coronary Syndrome Guidelines Stress Theres Nothing Stable About CAD, Effect of Icosapent Ethyl on Progression of Coronary Atherosclerosis in Patients With Elevated Triglycerides on Statin Therapy: The EVAPORATE Study, The PROSPECT ABSORB Trial: Randomized Evaluation of Vulnerable Plaque Treatment with Percutaneous Coronary Intervention, Integration of Non-Invasive and Invasive Imaging for the Detection of Vulnerable Plaques and Patients. Mosavi SS, Rabizadeh S, Yadegar A, Seifouri S, Mohammadi F, Qahremani R, Salehi SS, Rajab A, Esteghamati A, Nakhjavani M. BMC Complement Med Ther. 2022 Nov 17;84:104846. doi: 10.1016/j.amsu.2022.104846. , low-attenuation plaque was a better predictor of future events than other commonly used measures, such as a cardiovascular risk score. Figure 1: Courtesy of Kazzi BE, Feldman DI, Blumenthal RS, Zadeh AA. privacy practices. Eur Heart J. We know that there are different compositions of the plaque, he said. Xing HY, Chen YH, Xu K, Huang DD, Peng Q, Liu R, Sun W, Huang YN. Federal government websites often end in .gov or .mil. A key mechanism underlying this phenomenon is that statins increase plaque density thereby paradoxically raising the Agatston CAC scoreas density is upweighted. Epub 2018 Jun 13. and transmitted securely. There have been several clinical studies many of them done here at Cleveland Clinic thatshow statins can reverse plaque buildup. This site needs JavaScript to work properly. While you won't need to eliminate grapefruit entirely from your diet, ask your doctor about how much grapefruit you can have. Accessibility National Library of Medicine Macroscopic calcification is uncommon in the early stages of atherosclerosis while its invariable presence during its later stages likely is related to decreasing inflammation and organization. Kadoglou NP, Khattab E, Velidakis N, Patsourakos N, Lambadiari V. Kardiol Pol. Therapeutic effects of resveratrol and Omega-3 in mice atherosclerosis: focus on histopathological changes. Components of the score including volume, area, and density were quantified. Statin therapy was associated with decreased plaque volume in low attenuation plaques and fibro-fatty plaques, but not in the calcified plaques. Drugs called statins can help with this, and so can eating a heart-healthy diet, exercising, and quitting smoking. Epub 2018 Aug 30. A key mechanism underlying this phenomenon is that statins increase plaque density thereby paradoxically raising the Agatston CAC scoreas density is upweighted. Statins are also found in the combination medications Caduet (atorvastatin + amlodipine) and Vytorin (simvastatin + ezetimibe). It showed that the risks of long-term use of statin drugs are low and the potential benefits are very high. A strong predictor you'll experience muscle aches when taking statins could be whether or not you read about the potential side effect. 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. NCI CPTC Antibody Characterization Program. Considering the calcium plaques alone, statin therapy was not associated with a change in plaque volume, but rather a transformation to more dense calcium. The site is secure. By Michael O'Riordan Statin therapy in patients with atherosclerotic cardiovascular disease (ASCVD) is associated with positive changes in the phenotype of coronary lesions, with data from a new study showing there is a shift towards more-stable, calcified lesions and less higher-risk plaque. Would you like email updates of new search results? We used logistic regression models to study the association of statin use with the presence of plaque components. Fasting diet: Can it improve my heart health? People with. In terms of the clinical message, Nicholls said the study has important implications for discussing how the drugs work with patients and the importance of lowering LDL-cholesterol levels. Disclaimer. health information, we will treat all of that information as protected health All rights reserved. Trends Cardiovasc Med. Doctors target smaller, unstable plaque. On average, subjects in both groups showed a 9.2 percent increase in plaque buildup. Damage to your liver. 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. It was unclear, however, whether the associations with events would be as strong as those in statin-nave populations. Total CAC and volume holds prognostic value in statin users; however, the effects of statin on plaque histology requires clinicians to interpret CAC scores while accounting for statin use. Epub 2019 Feb 10. Of the seven different statins on the market, six are available generically ( TABLE 1 ). Statins include atorvastatin (Lipitor), fluvastatin (Lescol XL), lovastatin (Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor, Ezallor) and simvastatin (Zocor, FloLipid). For patients treated with statins and those who were not, coronary lesions with a higher proportion of calcium showed less overall plaque progression ( -0.003; P < 0.001 for both groups). We know that statins reduce the risk of heart attacksthats been proven many, many timesso we wanted to know whether statins increase the good plaque, the very dense calcium, and decrease the very-high-risk plaque.. The https:// ensures that you are connecting to the Stroke. Role of coronary artery calcium for stratifying cardiovascular risk in adults with hypertension. 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. This was especially evident in the statin group, where smaller plaque progression was observed for both high-density and very densely calcified plaques, as opposed to the non-statin group, in which smaller plaque progression only occurred in the very densely calcified plaques. We hypothesized that statin-induced plaque regression can be monitored clinically by the combined transesophageal and surface-coil MRI approach, is significantly associated with its lipid-lowering effect, and can be detected noninvasively earlier than previously reported. A total of 2,458 coronary lesions were assessed. Its like a rock that doesnt grow.. Therefore, this may suggest one possible mechanism by which statins induce plaque regression and decrease cardiovascular events while the CAC score remains unchanged or increases. 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. The benefit of taking statins likely outweighs the small risk to have the blood sugar level go up. Alonso R, et al. Epub 2018 Aug 7. 2023 American College of Cardiology Foundation. 2-7 Three available branded formulations are pitavastatin (Livalo), simvastatin oral suspension (FloLipid), and lovastatin extended-release (Altoprev). Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrao R.. Quantification of coronary artery calcium using ultrafast computed tomography. Complicating interpretation is the inclusion of only fatal events and the relatively elevated, but still low, mortality rate in statin users versus non-users with a zero CAC score. Nevertheless, the direct effects of statin treatment on the composition of atherosclerotic plaques remain elusive. Assessing individual risk can be difficult when dependent solely on epidemiologic derived risk estimators. ribeye steak), liver, and egg yolks. Statins use and coronary artery plaque composition: results from the International Multicenter CONFIRM Registry. To eliminate grapefruit entirely from your diet, exercising, and lovastatin extended-release ( Altoprev ) the findings that... For carrying blood to various vital organs of the seven different statins the. Feb 14 ; 14 ( 4 ):797. doi: 10.3390/nu14040797 key mechanism underlying this phenomenon that! And Vytorin ( simvastatin + ezetimibe ) often end in.gov or.mil your! Reset your password or.mil the potential benefits are very high likely to be reassured by brands. On a statin, low-attenuation plaque was a better predictor of future events than other commonly used,! 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