Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment

Veit Sandfort, Shenghan Lai, Mark A. Ahlman, Marissa Mallek, Songtao Liu, Christopher Sibley, Evrim B. Turkbey, João A.C. Lima, David A. Bluemke

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: This study aimed to determine the relationship of statin therapy and cardiovascular risk factors to changes in atherosclerosis in the carotid artery.

METHODS AND RESULTS: Carotid magnetic resonance imaging was used to evaluate 106 hyperlipidemic participants at baseline and after 12 months of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) treatment. Multivariable logistic regression was used to determine factors associated with progression (change in carotid wall volume >0) or regression (change ≤0) of carotid atherosclerosis. Computed tomography coronary calcium scores were obtained at baseline for all participants. The median age was 65 years (interquartile range 60-69 years), and 63% of the participants were male. Body mass index >30, elevated C-reactive protein, and hypertension were associated with increased carotid wall volume (obesity: odds ratio for progression 4.6, 95% CI 1.8-12.4, P<0.01; C-reactive protein: odds ratio for progression 2.56, 95% CI 1.17-5.73, P=0.02; hypertension: odds ratio 2.4, 95% CI 1.1-5.3, P<0.05). Higher statin dose was associated with regression of carotid wall volume (P<0.05). In multivariable analysis, obesity remained associated with progression (P<0.01), whereas statin use remained associated with regression (P<0.05). Change in atheroma volume in obese participants was +4.8% versus -4.2% in nonobese participants (P<0.05) despite greater low-density lipoprotein cholesterol reduction in obese participants.

CONCLUSIONS: In a population with hyperlipidemia, obese patients showed atheroma progression despite optimized statin therapy.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01212900.

Original languageEnglish (US)
JournalJournal of the American Heart Association
Volume5
Issue number7
DOIs
StatePublished - Jul 13 2016
Externally publishedYes

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Atherosclerosis
Obesity
Odds Ratio
Atherosclerotic Plaques
C-Reactive Protein
Hypertension
Carotid Artery Diseases
Hyperlipidemias
Carotid Arteries
LDL Cholesterol
Oxidoreductases
Body Mass Index
Therapeutics
Logistic Models
Tomography
Magnetic Resonance Imaging
Clinical Trials
Calcium
Population

Keywords

  • carotid artery
  • carotid magnetic resonance imaging
  • obesity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Sandfort, V., Lai, S., Ahlman, M. A., Mallek, M., Liu, S., Sibley, C., ... Bluemke, D. A. (2016). Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment. Journal of the American Heart Association, 5(7). https://doi.org/10.1161/JAHA.116.003621

Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment. / Sandfort, Veit; Lai, Shenghan; Ahlman, Mark A.; Mallek, Marissa; Liu, Songtao; Sibley, Christopher; Turkbey, Evrim B.; Lima, João A.C.; Bluemke, David A.

In: Journal of the American Heart Association, Vol. 5, No. 7, 13.07.2016.

Research output: Contribution to journalArticle

Sandfort, V, Lai, S, Ahlman, MA, Mallek, M, Liu, S, Sibley, C, Turkbey, EB, Lima, JAC & Bluemke, DA 2016, 'Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment', Journal of the American Heart Association, vol. 5, no. 7. https://doi.org/10.1161/JAHA.116.003621
Sandfort, Veit ; Lai, Shenghan ; Ahlman, Mark A. ; Mallek, Marissa ; Liu, Songtao ; Sibley, Christopher ; Turkbey, Evrim B. ; Lima, João A.C. ; Bluemke, David A. / Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment. In: Journal of the American Heart Association. 2016 ; Vol. 5, No. 7.
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abstract = "BACKGROUND: This study aimed to determine the relationship of statin therapy and cardiovascular risk factors to changes in atherosclerosis in the carotid artery.METHODS AND RESULTS: Carotid magnetic resonance imaging was used to evaluate 106 hyperlipidemic participants at baseline and after 12 months of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) treatment. Multivariable logistic regression was used to determine factors associated with progression (change in carotid wall volume >0) or regression (change ≤0) of carotid atherosclerosis. Computed tomography coronary calcium scores were obtained at baseline for all participants. The median age was 65 years (interquartile range 60-69 years), and 63{\%} of the participants were male. Body mass index >30, elevated C-reactive protein, and hypertension were associated with increased carotid wall volume (obesity: odds ratio for progression 4.6, 95{\%} CI 1.8-12.4, P<0.01; C-reactive protein: odds ratio for progression 2.56, 95{\%} CI 1.17-5.73, P=0.02; hypertension: odds ratio 2.4, 95{\%} CI 1.1-5.3, P<0.05). Higher statin dose was associated with regression of carotid wall volume (P<0.05). In multivariable analysis, obesity remained associated with progression (P<0.01), whereas statin use remained associated with regression (P<0.05). Change in atheroma volume in obese participants was +4.8{\%} versus -4.2{\%} in nonobese participants (P<0.05) despite greater low-density lipoprotein cholesterol reduction in obese participants.CONCLUSIONS: In a population with hyperlipidemia, obese patients showed atheroma progression despite optimized statin therapy.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01212900.",
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AU - Sibley, Christopher

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