Abstract 18305: Statin Use is Associated with Change in Coronary Artery Calcium Density: The Dallas Heart Study
Background: Statins are associated with lower CVD rates, but do not alter the progression of coronary artery calcium (CAC) burden over time. Recently, CAC density has been shown to have an inverse association with CVD. We sought to explore this paradox by determining if statins are associated with changes in CAC density.
Methods: Subjects from the Dallas Heart Study, a multiethnic, population-based sample, underwent paired CAC scanning 7 years apart. Those with prevalent calcium on both the first and second scan were included. CAC density was derived by dividing the Agatston score by the area score as described by Criqui et al. Multivariable mixed model linear regression was used to determine the difference in CAC density and CAC volumetric score change over time between subjects who had never taken statins compared to those initiated on statins between the two scans. Data were adjusted for age, sex, and race, and baseline and follow-up total cholesterol, HDL-C, smoking, diabetes, systolic blood pressure, and BMI.
Results: Among 512 subjects in the study, 48% were female, 49% black, the mean age was 49, and median Agatston score 12. Statins were initiated in 24% of subjects between the two scans. The mean CAC density was numerically higher at baseline among incident statin users compared to never statin users (2.13 vs. 2.00) and at follow up (2.84 vs. 2.58). In multivariable analysis, statin use was associated a greater increase in CAC density compared to never use (difference 0.19, p=0.04). In contrast, there was no difference in change in CAC volume, a measure of CAC burden, between statin users and never users in multivariable analysis (p=0.44).
Conclusion: Statin use is associated with change in CAC density but not change in CAC volume. These data suggest that statins promote plaque stability but do not reduce the quantity of calcified plaque burden, and provide a conceptual framework for understanding the interplay between statins and CAC changes from serial scans.
Author Disclosures: B.S. Patel: None. A.R. Paixao: None. B.D. Levine: None. S. Abbara: None. R.M. Peshock: None. A. Khera: None.
- © 2014 by American Heart Association, Inc.