Hemodynamic change of coronary atherosclerotic plaque after statin treatment: A serial follow-up study by computed tomography-derived fractional flow reserve

Abstract

BACKGROUND: Whether statin treatment can improve hemodynamic status of coronary atherosclerotic plaque remains un-known. It is of clinical interest to explore the hemodynamic change of coronary lesions after statin treatment. METHODS AND RESULTS: Consecutive patients with intermediate pre-test probability of coronary artery disease were pro-spectively enrolled and underwent baseline coronary computed tomography angiography (CCTA) as well as follow-up CCTA. The primary end point was to determine the lesion-specific change of △computed tomography-derived fractional flow reserve (△CT-FFR, defined as the change of CT-FFR value across each lesion) after rosuvastatin treatment. The secondary end point was to compare the change of other plaque characteristics according to serial CCTA findings. 152 patients (mean age: 67.1±9.7 years, 100 men, mean follow-up duration of 13.9±2.5 months) were finally included. In non-calcified plaque subgroup, △CT-FFR was significantly lower at follow-up compared with baseline (0.051±0.010 versus 0.035±0.012, P=0.013). All other parameters were not found to be significantly different between baseline and follow-up CCTA measurements. In calcified plaque and mixed plaque subgroups, all parameters showed no significant differences between baseline and follow-up CCTA groups (P>0.05 for all). According to multivariate regression analysis, non-calcified plaque was >2 times more likely than calcified plaque to observe the decrease of △CT-FFR (adjusted hazard ratio: 2.05 [1.03–4.09], P=0.042). CONCLUSIONS: In patients with mild to intermediate coronary stenosis, rosuvastatin treatment resulted in a reduction in lesion-specific △CT-FFR at mid-term follow-up. This hemodynamic improvement was mainly observed for non-calcified lesions.