Abstract 2435: Simvastatin Attenuates Plaque Inflammation- Evaluation by Fluorodeoxyglucose Positron Emission Tomography -
BACKGROUND: Inflammation plays a key role in progression and destabilization of atherosclerotic plaque. [18F]-fluorodeoxyglucose positron emission tomography (18FDG-PET) is a promising tool for visualizing inflammation of atherosclerotic plaque. Anti-inflammatory action is one of the pleiotropic effects of statins.
OBJECTIVE: We investigated whether simvastatin attenuates plaque inflammation by using 18FDG-PET co-registered with computed tomography.
METHODS and RESULTS: Forty-three consecutive subjects, who underwent 18FDG-PET for cancer screening and had 18FDG uptakes in the thoracic aorta and/or the carotid arteries, were randomized to either statin group receiving simvastatin (n=21) or diet group receiving dietary managements (n=22). The maximum standardized uptake values (SUVs) were measured in individual plaques, and were averaged for analysis of the subject-wise results. The responses were assessed after 3-month treatments. PET revealed 117 and 123 18FDG-positive plaques in the statin and diet groups, respectively. Simvastatin, but not diet alone, attenuated plaque 18FDG uptakes and decreased the SUVs (p<0.01). Simvastatin reduced low-density lipoprotein cholesterol (LDL) by 30% (p<0.01) and increased high-density lipoprotein cholesterol (HDL) by 15% (p<0.01), whereas LDL and HDL levels were not changed in the diet group. In the statin group, the decrease in the SUV was well correlated with the HDL elevation (p<0.01), but not with the LDL reduction.
CONCLUSIONS: 18FDG-PET visualized plaque inflammation and simvastatin attenuated it. The LDL-independent effects of simvastatin may participate in the beneficial effect. 18FDG-PET has a potential for visually monitoring plaque inflammation and therapeutic effectiveness of statins.