Effects of Pitavastatin on Lipid-rich Carotid Plaques Studied Using High-resolution Magnetic Resonance Imaging

Feng, Tao; Huang, Xiaolun; Liang, Qundi; Liang, Yun; Yao, Yuan; Feng, Li; Wu, Wenjun; Xiao, Xuehong; Han, Ying

doi:10.1016/j.clinthera.2017.01.013

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…The latest prospective studies [22,33] using 3T MRI imaging have confirmed the statin-induced reduction in lipid percentage and lipid volume within the carotid plaque after intensive statin therapy. Notably, MRI images showed a dose-dependent counterregulatory effect of pitavastatin (4 mg/d vs. 2 mg/d) on lipid core, plaque thickness, and lumen area [22]. In parallel, MRI can detect IPN, which is associated with a high risk of plaque rupture and consequent events [34][35][36].…”

Section: Effects Of Statins On Mri-based Carotid Plaque Vulnerabilitymentioning

confidence: 90%

“…Lipid-core regression can be a representative mechanism of statin-induced plaque stabilization [32]. The latest prospective studies [22,33] using 3T MRI imaging have confirmed the statin-induced reduction in lipid percentage and lipid volume within the carotid plaque after intensive statin therapy. Notably, MRI images showed a dose-dependent counterregulatory effect of pitavastatin (4 mg/d vs. 2 mg/d) on lipid core, plaque thickness, and lumen area [22].…”

Section: Effects Of Statins On Mri-based Carotid Plaque Vulnerabilitymentioning

confidence: 96%

“…High-resolution MRI has been recently proposed for the evaluation of atherosclerotic plaque vulnerability. MRI can illustrate in detail the components of the atherosclerotic plaque, arterial wall, and surrounding soft tissues [21][22][23][24]. Notably, it can adequately quantify the main features of the vulnerable plaque, lPH, ulceration, lipid-rich necrotic core (LRNC), calcification, intraplaque neovascularization (IPN), and inflammation [25][26][27].…”

Section: Effects Of Statins On Mri-based Carotid Plaque Vulnerabilitymentioning

confidence: 99%

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A new approach of statin therapy in carotid atherosclerosis: Targeting indices of plaque vulnerability on the top of lipid-lowering. A narrative review

et al. 2022

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Novel imaging techniques and biomarkers have emerged as surrogate markers of carotid plaque vulnerability. In parallel, statin administration in patients with established carotid atherosclerosis not requiring revascularization has reduced the number of consequent cerebrovascular events. This reduction is not only attributed to the lipid-lowering properties of statins but also to their pleiotropic actions. The present literature review aimed to summarize the stabilizing effects of statins on carotid plaques based on imaging modalities and biomarkers and propose an alternative approach to their implementation. Moreover, we assessed the perioperative use of statins in patients undergoing carotid revascularization and the impact of aggressive vs. conventional statin therapy. Recent studies using: (1) ultrasound indices of plaque echogenicity; (2) fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) scans for plaque inflammation assessment; or (3) magnetic resonance imaging (MRI) scans quantifying intraplaque hemorrhage, and lipid-rich necrotic core (LRNC) have shown quite promising results in evaluation of carotid plaque vulnerability. Based on those imaging modalities, a growing number of studies have demonstrated a very modest carotid plaque regression due to/induced by statins, while their stabilizing impact is disproportionally higher. Other studies assaying several biomarkers (e.g. inflammation, etc.) have confirmed a statin-induced carotid plaque stabilization. All the aforementioned benefits followed a dose-dependent pattern of statins, on top of the low-density lipoprotein cholesterol (LDL-C) target in current guidelines. In the case of symptomatic patients with carotid atherosclerosis suitable for revascularization, robust evidence implicates a significant statin-related reduction of perioperative cardiovascular risk only in patients undergoing endarterectomy.

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Section: Effects Of Statins On Mri-based Carotid Plaque Vulnerabilitymentioning

confidence: 90%

Section: Effects Of Statins On Mri-based Carotid Plaque Vulnerabilitymentioning

confidence: 96%

Section: Effects Of Statins On Mri-based Carotid Plaque Vulnerabilitymentioning

confidence: 99%

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A new approach of statin therapy in carotid atherosclerosis: Targeting indices of plaque vulnerability on the top of lipid-lowering. A narrative review

et al. 2022

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“…We also explored the relationship between the mean LRNC volumes and the mean LDL-C levels at various time points. Although several previous studies found that changes in the LRNC were significantly correlated with LDL-C levels (22,32,36), the reported LRNC volume changes varied across the reviewed studies, possibly due to the different study populations, designs, and statin regimens. The bubble chart showing the results across included studies is shown in Figure 4.…”

Section: The Relationship Between Lrnc Volumes and Ldl Levelsmentioning

confidence: 92%

Assessment of Therapeutic Response to Statin Therapy in Patients With Intracranial or Extracranial Carotid Atherosclerosis by Vessel Wall MRI: A Systematic Review and Updated Meta-Analysis

Zhou

Wang

Sun

et al. 2021

Front. Cardiovasc. Med.

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Background and Aims: Statin therapy is an essential component of cardiovascular preventive care. In recent years, various vessel wall MRI (VW-MRI) techniques have been used to monitor atherosclerosis progression or regression in patients with extracranial or intracranial large-artery atherosclerosis. We aimed to perform a systematic review and meta-analysis on the effects of statin therapy on plaque evolution as assessed by VW-MRI.Materials and Methods: Prospective studies investigating carotid and intracranial atherosclerotic plaques in patients on statin therapy monitored by serial VW-MRI were systematically identified in the literature. The plaque burden and lipid-rich necrotic core (LRNC) volume of carotid plaque and the imaging features of intracranial plaques were extracted and summarized. For studies investigating carotid artery wall volume and LRNC volume, combined estimates were derived by meta-analysis.Results: The study identified 21 studies of carotid plaque and two studies of intracranial plaque. While 16 studies investigating carotid plaques that included 780 patients by High-resolution VW-MRI were included in the meta-analysis. There was no significant change in carotid wall volume from baseline to 12 months. A significant change in LRNC volume was observed at > 12 months compared with baseline (Effect = −10.69, 95% CI = −19.11, −2.28, P < 0.01), while no significant change in LRNC volume at 3–6 months or 7–12 months after statin therapy initiation in 6 studies. Increases in fibrous tissue and calcium and reduction in neovascularization density of the plaque were seen in 2/3 studies (including 48/59 patients), 1/3 studies (including 17/54 patients), and 2/2 studies (including 71 patients) after statin therapy, respectively. Two studies with 257 patients in intracranial atherosclerosis showed that statins could effectively decrease wall volume and plaque enhancement volume.Conclusions: Collective data indicated that statins could potentially stabilize carotid plaques by significantly reducing LRNC with 1 year of therapy as shown on serial carotid VW-MRI. There was no significant decrease in wall volume, which nonetheless indicated that plaque composition changes might be more sensitive to response monitoring than wall volume. It is likely that more sensitive, clinically relevant, and preferably quantitative indicators of therapeutic effects on intracranial vessel plaque morphology will be developed in the future.

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“…У питавастатина доказан широкий спектр плейотропных эффектов, главные из которых -это подавление асептического воспаления в сосудистой стенке, снижение активности окисления липидов, восстановление эндотелиальной функции, предупреждение тромбообразования, повышение уровня адипонектина и экспрессии тканевого активатора плазминогена типа 1, отсутствие негативного влияния на метаболизм глюкозы и улучшение функции почек [16][17][18]. Сочетание выраженного гипохолестеринемического эффекта с доказанной плейотропной активностью питавастатина лежит в основе положительных морфофункциональных изменений в артериях, проявляемых не только в стабилизации атеромы за счет увеличения толщины покрышки, уменьшения липидного ядра, подавления процессов воспаления, но и в уменьшении объема атеромы (в регрессе) [19][20][21].…”

Section: результатыunclassified

Optimizing therapy for cardiovascular diseases: proven organ-protective and preventive effects of pitavastatin and lercanidipine: A review

Бубнова¹

2022

CardioSomatics

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The article aims to systematize the available data on the current use of statins and calcium channel antagonists (CA) for cardiovascular disorders therapy and to analyze the results of clinical trials focused on pitavastatin and lercanidipine. The article addresses the safety and tolerability of statins and CA and their use in the treatment of various conditions. Pharmacological features, preventive and organ-protective effects of pitavastatin and lercanidipine are described. The publications from the MEDLINE/PubMed, Scopus, Cochrane Library, eLIBRARY, and Google Scholar databases over the past 25 years were analyzed. The evidence presented in the article warrants the more extensive use of statins and CA in the treatment of patients with cardiovascular disease.

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Effects of Pitavastatin on Lipid-rich Carotid Plaques Studied Using High-resolution Magnetic Resonance Imaging

Cited by 7 publications

References 24 publications

A new approach of statin therapy in carotid atherosclerosis: Targeting indices of plaque vulnerability on the top of lipid-lowering. A narrative review

A new approach of statin therapy in carotid atherosclerosis: Targeting indices of plaque vulnerability on the top of lipid-lowering. A narrative review

Assessment of Therapeutic Response to Statin Therapy in Patients With Intracranial or Extracranial Carotid Atherosclerosis by Vessel Wall MRI: A Systematic Review and Updated Meta-Analysis

Optimizing therapy for cardiovascular diseases: proven organ-protective and preventive effects of pitavastatin and lercanidipine: A review

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