Abstract 16353: Triglyceride Reduction With Omega-3 Fatty Acids is Associated With Regression of Coronary Plaque Volume in Subjects With Coronary Artery Disease on Maximal Statin Therapy
Introduction: High-dose statin treatment resulted in coronary plaque regression measured by intravascular ultrasound. The benefit of triglyceride (TG) reduction on plaque regression with maximal statin therapy is unknown.
Hypothesis: Reduction of TG may reduce the fatty component of coronary plaque and lead to plaque regression in the setting of maximal statin therapy.
Methods: 200 subjects with stable CAD were randomized to either 3.36 g omega-3 fatty acids (1.86 g eicosapentaenoic acid + 1.5 g docosahexaenoic acid) or no omega-3 fatty acids (control) daily for 30 months. All received statin to lower LDL-C < 80 mg/dL. Using coronary computed tomographic angiography, we measured the indexed plaque volume (volume [mm3] divided by segment length in mm) of fatty, fibrous, non-calcified, calcified and total plaque volume at baseline and 30-month follow-up. Results for the total group were stratified by regression or progression of coronary plaque.
Results: Baseline median TG levels in the 2 groups were 120 and 122 mg/dL, respectively, and baseline LDL-C levels were 74 and 78 mg/dL, respectively. TG levels were significantly lower in the regression group at 30-month follow-up; otherwise, there were no differences (Table). Those with regression had reductions of 11.5%, 8.3%, 9.9% and 2.7% in fatty, fibrous, non-calcified and total plaque volumes, respectively, and a 14.9% reduction in TG. Those with progression had increases of 17.0%, 14.5%, 16.4% and 20.1% in fatty, fibrous, non-calcified and total plaque volumes, respectively, and a 1.3% increase in TG level.
Conclusions: Regression of plaque volume occurred in those with TG reductions whereas progression occurred in those who had no change in TG level. These results suggest that reduction of TG considered in the “normal” range (120 mg/dL) provides additional benefit to maximal statin therapy on reducing plaque volume. These results support more aggressive management of TG levels when assessing cardiovascular risk.
Author Disclosures: T.K. Elajami: None. A. Alfaddagh: None. F.K. Welty: None.
- © 2016 by American Heart Association, Inc.