Effect of Atorvastatin on Serial Changes in Coronary Physiology and Plaque Parameters

Lee, Cheol Hyun; Hwang, Jongmin; Kim, In-Cheol; Park, Hyoung‐Seob; Yoon, Hyuck–Jun; Kim, Hyungseop; Han, Seongwook; Hur, Seung‐Ho; Kim, Kwon-Bae; Kim, Jin Young; Chung, Jun‐Won; Lee, Joo Myung; Doh, Joon‐Hyung; Shin, Eun‐Seok; Koo, Bon‐Kwon; Nam, Chang‐Wook

doi:10.1016/j.jacasi.2022.07.010

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…These findings highlight the potential benefits of optimal control of blood lipid and glucose levels in improving coronary physiology. Several studies have demonstrated the relationship between LDL-C control and functional progression, with evidence suggesting that achievement of optimal LDL-C levels can lead to improvements in FFR or QFR values in patients with CAD ( 25 - 27 ). In line with these studies, our results also showed that coronary physiological burden could be modified by achieving optimal levels of LDL-C.…”

Section: Discussionmentioning

confidence: 99%

The relationship between glycemic risk and longitudinal changes in total physiological atherosclerotic burden in patients with coronary artery disease

Chu,

Lai,

Yao

et al. 2024

Quant Imaging Med Surg

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Background The effects of glycemic status on coronary physiology have not been well evaluated. This study aimed to investigate changes in coronary physiology by using angiographic quantitative flow ratio (QFR), and their relationships with diabetes mellitus (DM) and glycemic control status. Methods This retrospective cohort study included 530 patients who underwent serial coronary angiography (CAG) measurements between January 2016 and December 2021 at Tongji Hospital of Tongji University. Based on baseline and follow-up angiograms, 3-vessel QFR (3V-QFR) measurements were performed. Functional progression of coronary artery disease (CAD) was defined as a change in 3V-QFR (Δ3V-QFR = 3V-QFR follow-up − 3V-QFR baseline ) ≤−0.05. Univariable and multivariable logistic regression analyses were applied to identify the independent predictors of coronary functional progression. Subgroup analysis according to diabetic status was performed. Results During a median interval of 12.1 (10.6, 14.3) months between the two QFR measurements, functional progression was observed in 169 (31.9%) patients. Follow-up glycosylated hemoglobin (HbA1c) was predictive of coronary functional progression with an area under the curve (AUC) of 0.599 [95% confidence interval (CI): 0.546–0.651; P<0.001] in the entire population. Additionally, the Δ3V-QFR values were significantly lower in diabetic patients with HbA1c ≥7.0% compared to those with well-controlled HbA1c or non-diabetic patients [−0.03 (−0.09, 0) vs. −0.02 (−0.05, 0.01) vs. −0.02 (−0.05, 0.02); P=0.002]. In a fully adjusted multivariable logistics analysis, higher follow-up HbA1c levels were independently associated with progression in 3V-QFR [odds ratio (OR), 1.263; 95% CI: 1.078–1.479; P=0.004]. Furthermore, this association was particularly strong in diabetic patients (OR, 1.353; 95% CI: 1.082–1.693; P=0.008) compared to patients without DM. Conclusions Among patients with established CAD, on-treatment HbA1c levels were independently associated with progression in physiological atherosclerotic burden, especially in patients with DM.

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Section: Discussionmentioning

confidence: 99%

The relationship between glycemic risk and longitudinal changes in total physiological atherosclerotic burden in patients with coronary artery disease

Chu,

Lai,

Yao

et al. 2024

Quant Imaging Med Surg

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“…In recent studies, it is claimed that newly created lipid indices, such as PAI, Framingham risk scoring, CRI I-II, and AC, are better than conventional lipid parameters (TC, LDL, TRG, and decreased HDL) in predicting cardiovascular events (31)(32)(33). Substantial evidence suggests that changes in serum lipid levels cause deterioration in CFR and that treatment of dyslipidemia may restore CFR (15,34,35). Two mechanisms come to mind while explaining why PAI, the logarithmic value of TRG/HDL, causes endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Does the Prevalence of Subclinical Coronary Atherosclerosis Increase in Primary Hyperparathyroidism; Coronary Flow Reserve and Plasma Aterogenic Index in Patients with Primary Hyperparathyroidism

Cetinkaya,

Kelesoğlu,

Gokay

et al. 2023

Preprint

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Introduction: The coronary flow reserve (CFR) is a sign of early-stage coronary artery disease (CAD). Plasma atherogenic index (PAI) is related to atherosclerosis and cardiovascular mortality. Therefore, our aim was to determine CFR and PAI in patients with primary hyperparathyroidism (PHPT) and investigate whether PAI can be used in the detection of early-stage CAD. Material and Methods: The sample was comprised of 44 patients with PTHT and 33 healthy volunteers. We defined CFR as the ratio of the hyperemic diastolic peak velocity to the baseline diastolic peak velocity. PAI values were calculated with the formula of log 10 triglyceride (TRG) / high-density lipoprotein (HDL). Result: The comparison of the groups for PAI and CFR demonstrated that PAI levels were significantly higher while CFR levels were significantly lower in the PTHT patients (p<0.01, p=0.01, respectively). The correlation analysis revealed that CFR was negatively correlated with PAI and TRG (PAI- p<0.0001 r=-0.537).The multivariate logistic regression analysis showed that only a high PAI level (OR: 151.6, 95% confidence interval (CI): 4.1-5480, p=0.006) was an independent predictor of reduction in CFR in PHPT patients. Conclusion: Overall, we found an independent correlation between PAI and CFR values. Hence, PAI may be useful in identifying PHPT patients facing a high risk of adverse cardiovascular events and may also allow early diagnosis of subclinical atherosclerosis.

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“…The clinical significance of changes in coronary physiology has been investigated by several wire-based or imaging-derived fractional flow reserve (FFR) parameters [ 9 , 10 , 11 , 18 , 19 ]. As reported in a previous study, the longitudinal physiological progression is slow, as evaluated by per-vessel FFR with a median decrease of 0.007 per year [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…In parallel, the overall lesion-specific QFR values also showed a slow progression rate (from 0.04 [0.02, 0.06] at baseline to 0.05 [0.03, 0.07] at follow-up). Despite coronary lesions progressing at a very slow rate in functional status, several studies, including a prospective trial, have demonstrated that intensive statin treatment could improve the hemodynamic status assessed by invasive or computational FFR [ 10 , 11 , 19 ], indicating that serial changes in coronary physiology could be a surrogate marker for monitoring the effect of medical treatments in patients with CAD. In this study, we further demonstrated that angiography-based QFR allowed the assessment of changes in coronary physiology of intermediate lesions and could be a useful quantitative index to evaluate coronary functional progression.…”

Section: Discussionmentioning

confidence: 99%

Impact of Radial Wall Strain on Serial Changes in Vascular Physiology in Patients with Intermediate Coronary Stenosis

Chu,

Lai,

Yan

et al. 2023

Rev. Cardiovasc. Med.

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Background: Coronary biomechanical stress contributes to the plaque rupture and subsequent events. This study aimed to investigate the impact of plaque biomechanical stability on the physiological progression of intermediate lesions, as assessed by the radial wall strain (RWS) derived from coronary angiography. Methods: Patients with at least one medically treated intermediate lesion at baseline who underwent follow-up coronary angiography over 6 months were included. The maximal RWS ( ) of the interrogated lesion was calculated from the baseline angiogram. The primary endpoint was to determine the association between baseline and the functional progression of coronary lesions, defined as an increase in the lesion-specific quantitative flow ratio (L- QFR, calculated as the absolute change in QFR across the lesion) on serial angiograms. Results: Among 175 lesions in 156 patients, 63 lesions showed an increase in L- QFR during a median follow-up period of 12.4 months. Baseline values were significantly higher in lesions with increased L- QFR than in those with stabilized or decreased L- QFR (11.8 [10.7, 13.7] vs .10.8 [9.7, 11.7]; p 0.001). Baseline presented an area under the curve of 0.658 (95% confidence interval [CI]: 0.572–0.743, p 0.001) for the prediction of increased L- QFR. After full adjustment for clinical and angiographic factors, a high ( 12) was found to be an independent predictor of functional lesion progression (odds ratio: 2.871, 95% CI: 1.343–6.138, p = 0.007). Conclusions: A high calculated from baseline angiograms was independently associated with the subsequent physiological progression in patients with intermediate coronary lesions.

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Effect of Atorvastatin on Serial Changes in Coronary Physiology and Plaque Parameters

Cited by 5 publications

References 33 publications

The relationship between glycemic risk and longitudinal changes in total physiological atherosclerotic burden in patients with coronary artery disease

The relationship between glycemic risk and longitudinal changes in total physiological atherosclerotic burden in patients with coronary artery disease

Does the Prevalence of Subclinical Coronary Atherosclerosis Increase in Primary Hyperparathyroidism; Coronary Flow Reserve and Plasma Aterogenic Index in Patients with Primary Hyperparathyroidism

Impact of Radial Wall Strain on Serial Changes in Vascular Physiology in Patients with Intermediate Coronary Stenosis

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