Abstract 19553: Statin Therapy is Associated with Improvement of Osteoporosis, Adipose Tissue and Coronary Atherosclerosis

Abstract

Background: There is a significant associations of osteoporosis with atherosclerosis. This study evaluates the effect of statin therapy on osteoporosis, coronary artery distensibility(CDI), vulnerable plaque composition and epicardial adipose tissue in subjects with intermediate risk for coronary artery disease.

Method: Two hundred and forty subjects underwent computed tomography angiography (age: 61±9 years, 60% male). CDI in left anterior descending artery (LAD) was defined as: [(Early-diastole - mid-diastole lumen cross section area(CSA))/(lumen CSA in mid-diastole x central pulse pressure) x1000]. Vulnerable plaque composite score(VPS) was measured using semi-quantified plaque volume (none, localized, intermediate, or diffuse) and severity of diseased coronaries (normal, mild, moderate, or severe) in non-calcified and mixed plaques based on AHA 15-segment model. Trabecular-BMD(mg/cc) of four consecutive thoracic-vertebrae below the left-main coronary artery slice-level was assessed. EAT, adipose tissue inside pericardial sac, was measured from slice level 15 mm above to the bottom of the heart.

Results: Osteoporosis was significant correlated with impaired CDI, VPS and EAT(p<0.05). Statin therapy was associated with increase in CDI and BMD (p<0.05). Similarly, statin therapy was associated with decrease in VPS of vulnerable plaque as well as EAT (p<0.05) (Table). Significant association between decrease in VPS of vulnerable plaque, and increase in BMD in response to statin therapy was observed, in which statin therapy was associated with 46% decrease in risk of osteoporosis and VPS (relative risk: 0.54, 95%CI:0.41-0.95, p=0.01)).

Conclusion: There a significant and independent association between decrease in EAT, VPS of vulnerable plaques, coronary vascular function improvement, and increase in BMD in response to statin therapy. This highlights the dual beneficial cardio- and osteoporosis-protective effects of statin therapy.