Effects of long-term statin-treatment on coronary atherosclerosis in patients with inflammatory joint diseases

Autoři: Mona Svanteson aff001;  Silvia Rollefstad aff003;  Nils-Einar Kløw aff001;  Jonny Hisdal aff004;  Eirik Ikdahl aff003;  Joseph Sexton aff005;  Ylva Haig aff001;  Anne Grete Semb aff003
Působiště autorů: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway aff001;  Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway aff002;  Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway aff003;  Department of Vascular Investigations, Oslo University Hospital, Aker, Oslo, Norway aff004;  Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226479



The effect of statins over time on coronary atherosclerosis in patients with inflammatory joint diseases (IJD) is unknown. Our aim was to evaluate the change in coronary plaque morphology and volume in long-term statin-treated patients with IJD.


Sixty-eight patients with IJD and carotid artery plaque(s) underwent coronary computed tomography angiography before and after a mean of 4.7 (range 4.0–6.0) years of statin treatment. The treatment target for low density lipoprotein cholesterol (LDL-c) was ≤1.8 mmol/L. Changes in plaque volume (calcified, mixed/soft and total) and coronary artery calcification (CAC) from baseline to follow-up were assessed using the 17-segment American Heart Association-model.


Median (IQR) increase in CAC after statin treatment was 38 (5–236) Agatston units (p<0.001). Calcified and total plaque volume increased with 5.6 (0.0–49.1) and 2.9 (0.0–23.5) mm3, respectively (p<0.001 for both). The median (IQR) change in soft/mixed plaque volume was -10 (-7.1–0.0), p = <0.001. Patients who had obtained the LDL-c treatment target at follow-up, experienced reduced progression of both CAC and total plaque volume compared to patients with LDL-c >1.8mmol/L (21 [2–143] vs. 69 [16–423], p = 0.006 and 0.65 [-1.0–13.9] vs. 13.0 [0.0–60.8] mm3, p = 0.019, respectively).


A progression of total atherosclerotic plaque volume in statin-treated patients with IJD was observed. However, soft/mixed plaque volume was reduced, suggesting an alteration in plaque composition. Patients with recommended LDL-c levels at follow-up had reduced atherosclerotic progression compared to patients with LDL-c levels above the treatment target, suggesting a beneficial effect of treatment to guideline-recommended lipid targets in IJD patients.

Klíčová slova:

Ankylosing spondylitis – Cardiovascular diseases – Coronary heart disease – Inflammation – Inflammatory diseases – Lipids – Lipoproteins – Statins


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