Abstract 513: Reversal of Vascular Inflammation by 12-week Atorvastatin
Background: FDG PET/CT has potentials for tracking inflammation within plaques and monitoring therapeutic response. We hypothesize subjects with documented atherosclerosis have higher arterial FDG activity which could be attenuated after 12-week atorvastatin therapy.
Methods: The study population comprised 43 subjects (32M, 64±11y) with documented atherosclerosis and 34 healthy controls (24M, 54±10y) who had normal carotid and vertebral arteries on ultrasound, no history of cardiovascular disease or statin use, and received repeat PET 1 to 4 (2.5±0.8) years apart. Patients with atherosclerosis received atorvastatin (40mg/d) for 12 weeks. Vascular FDG activity (average of SUVmax from aorta to iliofemoral arteries in 7 regions), coronary calcification, abdominal fat measured by PET/CT, lipid profiles and circulating biomarkers were compared.
Results: Patients with atherosclerosis were older, had significantly higher hs-CRP and mean SUVmax than controls (P<0.05). In control group, mean SUVmax positively correlated with hs-CRP (r = 0.42) and TG (r = 0.56; P<0.05). In addition, vascular FDG activity slightly increased after 2.5±0.8 years (P = NS). In patients with atherosclerosis, mean SUVmax correlated with age (r = 0.61), body mass index (r = 0.60), abdominal visceral fat volume (r = 0.65), coronary calcification (AJ-130, r = 0.40), LDL (r = 0.54), MMP-9 (r = 0.46) and aP2 (r = 0.67; P<0.05). After 12-week therapy, significant decline of hs-CRP, E-selectin, MMP-9, MCP-1, follistatin, aP2 and vascular FDG activity were noted, but not coronary calcification or abdominal visceral fat volume.
Conclusions: Our study confirmed that patients with atherosclerosis have higher vascular inflammation. Twelve weeks atorvastatin therapy could decrease levels of hs-CRP, E-selectin, MMP-9, MCP-1, follistatin, aP2, as well as arterial FDG uptake. It suggests that regression of arterial inflammation could be achieved by 12-week moderate dose of atorvastatin therapy.