Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2021; 9(4): 812-821
Published online Feb 6, 2021. doi: 10.12998/wjcc.v9.i4.812
Effects of different statins application methods on plaques in patients with coronary atherosclerosis
Xia Wu, Xiao-Bo Liu, Ting Liu, Wen Tian, Yu-Jiao Sun
Xia Wu, Xiao-Bo Liu, Wen Tian, Yu-Jiao Sun, Department of Geriatrics, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Ting Liu, Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Wu X participated in the design of the study, acquired the data, performed the statistical analysis, and drafted the manuscript; Liu XB acquired and analysed the data; Liu T and Tian W acquired the data; Sun YJ conceived of the study, participated in its design and coordination, helped to draft the manuscript, and provided critical revision for important intellectual content; all authors approved the final version of the article to be published.
Institutional review board statement: The study was approved by the ethics committee of the First Affiliated Hospital of China Medical University.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Jiao Sun, MD, Chief Doctor, Department of Geriatrics, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping Ward, Shenyang 110001, Liaoning Province, China. sunyujiaomy08@sina.cn
Received: September 28, 2020
Peer-review started: September 28, 2020
First decision: November 3, 2020
Revised: November 23, 2020
Accepted: December 10, 2020
Article in press: December 10, 2020
Published online: February 6, 2021
Abstract
BACKGROUND

Discontinued application of statins may be related to adverse cardiovascular events. However, it is unclear whether different statins administration methods have effects on coronary artery plaques.

AIM

To evaluate the effects of different statins application methods on plaques in patients with coronary atherosclerosis.

METHODS

A total of 100 patients diagnosed with atherosclerotic plaque by coronary artery computed tomography were continuously selected and divided into three groups according to different statins administration methods (discontinued application group, n = 32; intermittent application group, n = 39; sustained application group, n = 29). The effects of the different statins application methods on coronary atherosclerotic plaque were assessed.

RESULTS

The volume change and rate of change of the most severe plaques were significantly reduced in the sustained application group (P ≤ 0.001). The volume change of the most severe plaques correlated positively with low-density lipoprotein (LDL-C) levels only in the sustained application group (R = 0.362, P = 0.013). There were no changes in plaques or LDL-C levels in the intermittent and discontinued application groups.

CONCLUSION

Continuous application of statins is effective for controlling plaque progression, whereas discontinued or intermittent administration of statins is not conducive to controlling plaques. Only with continuous statins administration can a reduction in LDL-C levels result in plaque volume shrinkage.

Keywords: Coronary atherosclerotic plaque, Statin, Coronary artery computed tomography, Low-density lipoprotein, Plaque volume

Core Tip: In this study, a connection between different ways to take the medicine of statins and changes in coronary atherosclerotic plaques was detected. The sustained application of statins reduced the volume of the most severe atherosclerotic plaques compared with intermittent and discontinued applications, suggesting that sustained application of statins plays an important role in treating atherosclerosis. In contrast, in the discontinued and intermittent application groups, coronary atherosclerotic plaques showed progression. These results suggest that statins are effective for the intervention of atherosclerotic plaques and should be applied consistently and continuously. Intermittent application not only increases the medication cost and patient burden but also may not be effective.