Assessing the dynamics of vulnerability of atherosclerotic plaques in patients on atorvastatin therapy based on coronary computed tomography angiography (CCTA) data

El Manaa H.E., Shabanova M.S., Gognieva D.G., Lomonosova A.A., Shchekochikhin D.Yu., Rozhkov A.N., Shariya M.A., Ternovoy S.K., Kopylov Ph.Y., Syrkin A.L.

Purpose. Assessing the dynamics of vulnerability of atherosclerotic plaques in patients with angina pectoris on atorvastatin therapy (40 mg for 10-12 months) based on coronary comput-ed tomography angiography (CCTA) data.

1 - Federal State Budgetary Educational Institution of Higher Edu-cation «St. Petersburg State Pedi-atric Medical University» of the Ministry of Healthcare of the Russian Federation. 2 - Federal State Budgetary Institution «Almazov National Medical Research Centre» of the Ministry of Healthcare of the Russian Federation. 3 - Federal State Budgetary Military Educational Institution of Higher Education «Military Medical Academy named by S.M. Kirov» of the Ministry of Defense of the Russian Federation. St. Petersburg

Materials and methods. The study prospectively enrolled 74 patients with angina pectoris not medicated with statins. All patients underwent CCTA. 30 patients with vulnera-bility of atherosclerotic plaques were selected for further observation and atorvastatin was administered to them at dose of 40 mg. Repeated tomography scans were recorded 10-12 months later. Images were analyzed by “Vitrea” workstation in a blind manner. Statistical processing was performed on SPSS version 11.5 software (BioStat). Results. Statistically insignificant decrease in: total plaque volume (from 188.64 ± 35.8 to 184.96 ± 34.45 mm3), low-attenuation plaque (from 60.46 ± 12.87 to 57.06 ± 12.34 mm3), degree of stenosis (from 41.6 ± 3.16 to 40.65 ± 3.26%), spotty calcification (from 86.0 to 90%), remodeling index (from 1.25 [1,0;1,4] to 1.1 [1,0;1,4]), napkin-ring sign (from 69.76 to 60%), irregularity of the contour (from 79.1 to 65%). LDL levels decreased from 3.23 ± 0.33 to 2.76 ± 0.27 mmol/L. Statistically significant decrease of total cholesterol was from 5.75 ± 0.45 to 4.42 ± 0.57 mmol/L. The study also revealed statistically significant positive correlation between decrease of LDL levels and total plaque volume decrease (R=0.51, P=0.002), mainly because of low-attenuation components. Conclusion. We review our experience of using CCTA for noninvasive monitoring of vulnerability of atherosclerotic plaques in dynamics and show that atherosclerotic plaques stabilize on long-term atorvastatin treatment.

 

Keywords: coronary computed tomography angiography, coronary artery disease, vulnerable atheroscle-rotic plaques, statins.

Corresponding author:H.E. El Manaa, e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: El Manaa H.E., Shabanova M.S., Gognieva D.G., Lomonosova A.A., Shche-kochikhin D.Yu., Rozhkov A.N., Shariya M.A., Ternovoy S.K., Kopylov Ph.Y., Syrkin A.L. As-sessing the dynamics of vulnerability of atherosclerotic plaques in patients on atorvastatin ther-apy based on coronary computed tomography angiography (CCTA) data. REJR 2018; 8 (3):164-173. DOI:10.21569/2222-7415-2018-8-3-164-173.

Received:07.07.18Accepted:26.07.18