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Carotid plaque volume and composition have high predictive value of cardiovascular coronary events. High-resolution magnetic resonance imaging (MRI) is a noninvasive imaging modality that enables the quantitative and compositional assessment of the carotid artery. To date, little is known regarding an effect of intensive lipid lowering therapy on carotid plaque characteristics. The purpose of the present study was to evaluate clinical factors that have an impact on plaque change using statin therapy.
Prospective, open-label blinded end-points trial was performed using 1.5-T MRI to image carotid atherosclerotic plaques. Patients with maximum carotid intima-media thickness (IMT) >= 1.8 mm as measured by ultrasound and a plasma LDL-C of more than 120 mg/dL without statin treatment were enrolled from 2007 to 2010. All patients were administrated by rosuvastatin 5mg/day after baseline MRI. MRI was performed at baseline and 24-month of follow-up. The endpoint was the change of necrotic core and plaque volume.
After 24 months, 38 patients had taken MRI scans to compare by reviewers blinded to clinical data, and temporal sequence of scans. LDL-C was significantly reduced from baseline by 46.6%. At 24 months, there was a significant decrease in the ratio of necrotic core and vessel volume, whereas plaque volume was no significant change. We found a linear association between the change of necrotic core and baseline body mass index (BMI). Analysis of covariance revealed that baseline BMI influenced the change of % necrotic core (p=0.0002).
The greater degree of carotid plaque stabilization was found according to the increase of baseline BMI after 24-month rosuvastatin treatment.