Abstract 5815: Effects of Atorvastatin on F-18 Fluorodeoxyglucose Accumulation on Positron Emission Tomography in Atherosclerotic Plaques: The EARDROP Study
In atherosclerosis, plaque vulnerability is strongly related to rupture, and vulnerable plaques contain numerous inflammatory cells, particularly macrophages, suggesting that inflammation is closely associated with plaque instability. Recently, it has been suggested that F-18 fluorodeoxyglucose (FDG) on positron emission tomography (PET) is a useful technique for detection of local inflamed atherosclerotic lesions. We therefore examined the effects of atorvastatin on F-18-FDG accumulations in atherosclerotic plaques at common carotid and ascending aorta. A total of 20 patients with dyslipidemia but not treated with medication were enrolled and imaged using F-18-FDG -PET and CT for baseline measurement. They were randomized to receive 20-mg or 5-mg atorvastatin after imaging and F-18-FDG -PET and CT were checked again 6 months later. Changes in the standard uptake value (SUV) of F-18-FDG-accumulation rate (plaque/integral plasma) between baseline and follow-up were evaluated. After atorvastatin treatment, serum C-reactive protein (CRP) levels, low-density lipoprotein (LDL) cholesterol levels and malondialdehyde-modified LDL (MDA-LDL) cholesterol levels were significantly reduced (CRP levels: from 1277±704 mg/dl to 609±314 mg/dl, p < 0.0001, LDL cholesterol levels: from 154±29 mg/dl to 98±29 mg/dl, p < 0.0001, MDA-LDL cholesterol levels: 178.4±70.8 IU/l to 125.4±49.7 IU/l, p < 0.0001, respectively). The maximum SUV significantly decreased at follow-up (common carotid arteries: from 1.36 ±0.13 g/dl to 1.28 ±0.22 g/dl, p = 0.047, ascending aorta: from 1.63 ±0.20 g/dl to 1.53 ±0.16 g/dl, p = 0.032, respectively). Notably, the decrease in the SUV was well correlated with reduction of serum CRP levels (common carotid arteries: r = 0.52, ascending aorta: r = 0.47, respectively), LDL cholesterol levels (common carotid arteries: r = 0.46, ascending aorta: r = 0.43, respectively) and MDA-LDL cholesterol levels (common carotid arteries: r = 0.47, ascending aorta: r = 0.43, respectively). Six-month atorvastatin treatment had anti-inflammatory effects and decreased SUV detected by F-18-FDG -PET, which might represent regression of aortic vulnerability.