Abstract 13329: MRI-Assessed Carotid Plaque Inflammation Decreases With Lipid Lowering Therapy
Background: Ktrans is a dynamic contrast-enhanced magnetic resonance (DCE-MRI) pharmacokinetic variable that has been correlated with plaque inflammation. We determined whether carotid plaque Ktrans decreases with intensive lipid intervention in an ancillary study to the AIM-HIGH Trial.
Methods: Ancillary study participants had carotid artery DCE-MRI scanning at Baseline and at on-trial Years 1 and/or 2; 102 participants had scans at ≥2 time-points. LDL-C was treated to a target of 40-80 mg/dL. Changes in Ktrans between baseline and later time points were assessed using the paired t-test.
Results: Participants were (mean±SD) age 62±9 years, 16% female, 23% with diabetes, and 80% with metabolic syndrome. All but 4 (4%) were on statins prior to study entry, and 72 (73%) had been on statins for >1 year. Baseline LDL-C decreased from 77±26 to 70± 19 mg/dL at Year 1 (-9.1%). Though Ktrans change (mean± SE) did not reach significance from Baseline to Year 1 (-4.2± 2.6 x 10-3 min-1, N=72, p=0.11), Ktrans change from Baseline to Year 2 was significant (-8.1± 3.4 x 10-3 min-1, N=59, p=0.02). Also, the annualized rate of decrease in Ktrans was significant in a combined analysis of all subjects with scans from at least 2 time points (N=102, p=0.04).
Conclusions: In CAD patients with well-treated lipids at baseline, further decrease in LDL was associated with a decrease in plaque inflammation, as detected by DCE-MRI. These results demonstrate the potential utility of DCE-MRI for serial monitoring, and suggest that aggressive lipid intervention continues to decrease plaque inflammation.
- © 2013 by American Heart Association, Inc.