Abstract 13260: Statin Intake is Associated with Progression of Coronary Artery Calcium Despite Lowering Risk for Coronary Events - The Heinz Nixdorf Recall Study
Objective: Beside their lipid lowering effect, statins are suggested to stabilize plaque. We aimed to determine, whether statins influence the progression of coronary artery calcification (CAC).
Methods: We included participants from the population based Heinz Nixdorf Recall Study free of cardiovascular disease. Subjects with statin intake at baseline were matched with subjects without statin intake by age, gender, diabetes, hypertension, smoking status, and CAC category. CAC score was determined from electron beam computed tomography at baseline and after five years. For analysis of CAC progression, we excluded subjects with revascularization between both examinations. Regression analysis was used to determine the association of statin intake with CAC progression, defined as difference of log-transformed CAC (log(CAC[t1]+1)- log(CAC[t0]+1)). Results are given as percent increase in CAC+1. Event rates between both groups were compared using Fischers-Exact test and association of statin intake with incident events was assessed using Cox regression.
Results: We compared 202 subjects with statin intake (mean age: 61.7±6.9 years, 51% male) with 404 without statin medication (mean age: 61.4±7.0 years, 51% male). Subjects taking statins had significantly lower LDL-cholesterol levels (130.3±30.5 vs. 151.8±35.9, p<0.0001). Despite comparable CAC-scores at baseline (median[Q1;Q3]:36.9[2.1;206.8] vs. 35.1[1.0;209.1], p=0.7), subjects taking statins had higher CAC progression (138±224% vs. 66.5±192%, p=0.0002). In regression analysis, subjects with statin intake had higher CAC progression then those without (%change of CAC+1 (95%CI): 42.9(18.5-72.4)%, p=0.0002). Participants with statin intake showed a tendency towards lower coronary event rate (4/205, 1.9%) compared to matched subjects (11/410, 2.7%; p=0.8), which converted into a hazard ratio of 0.74 (0.24-2.33, p=0.6).
Conclusion: Statin intake is associated with increased CAC progression in the general population, however, in this case CAC progression does not lead to increased risk. Notwithstanding other explanations like bias by indication, our results may support the hypothesis of a plaque stabilizing effect of statins, which might be reflected by an increase in CAC.
Author Disclosures: I. Dykun: None. N. Lehmann: None. H. Kälsch: None. M. Bauer: None. S. Moebus: None. S. Möhlenkamp: None. R. Erbel: None. A.A. Mahabadi: None.
- © 2014 by American Heart Association, Inc.