Abstract 3265: Influence of a Lipid Lowering Therapy on Calcified and Non-Calcified Coronary Plaques Monitored by Multi-Slice Detector Computed Tomography: Results of the New Age-II-Study
Purpose: Multi-slice detector computed tomography (MSCT) is an accurate non-invasive modality to detect and classify different stages of atherosclerosis. The aim of the “New Age-II-Study” was to detect coronary lesions in male persons without established coronary artery disease (CAD), but with distinct cardiovascular risk profile, as well as to assess the effect of a lipid lowering therapy (LLT) with 20 mg atorvastatin after one year.
Methods: 46 male patients (pts) (61±10 years) with an elevated risk for CAD (PROCAM score > 3. quintile) without LLT were included. Native- and contrast-enhanced scans were performed in all pts. 27/46 pts received a follow-up scan (after 488 ± 138 days). Coronary plaque burden (CPB) was assessed volumetrically.
Results: The prevalence of CAD was 83% (38/46 pts). 11% (5/46) without coronary calcifications still had non-calcified plaques. Total cholesterol and LDL-cholesterol levels decreased significantly under LLT (225±41 mg/dl vs. 162 ± 37 mg/dl, p<0.0001, 148±7 mg/dl vs. 88±5 mg/dl, p< 0.001). On follow up, calcium score and CPB remained unchanged (Agatston score: 261±301 vs. 282±360; CPB: 0.149±0.108 vs. 0.128±0.075 mL, p<0.05), whereas mean plaque volume of non-calcified plaques decreased significantly from 0.042±0.029 mL vs. 0.030±0.014 mL (p<0.05, mean reduction 0.012±0.017 mL or 24±13%).
Conclusions: Statin therapy led to a significant reduction of non-calcified plaque burden which was not reflected in calcium scoring or total plaque burden. This finding might explain the risk reduction after the initiation of statin therapy. MSCT has the potential to monitor medical treatment in patients with coronary atherosclerosis.