C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trials
ObjectiveSeveral clinical trials have indicated that statins stabilize and reverse atherosclerotic plaque. However, different studies have provided inconsistent findings regarding mechanisms and influencing factors of plaque regression under statin therapy. Apart from lipid-lowering effect, statins...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.989527/full |
| _version_ | 1797984264638169088 |
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| author | Darui Gao Darui Gao Darui Gao Rong Hua Rong Hua Rong Hua Dina Jiesisibieke Yanjun Ma Yanjun Ma Yanjun Ma Chenglong Li Chenglong Li Chenglong Li Sijing Wu Qian Ma Wuxiang Xie Wuxiang Xie Wuxiang Xie |
| author_facet | Darui Gao Darui Gao Darui Gao Rong Hua Rong Hua Rong Hua Dina Jiesisibieke Yanjun Ma Yanjun Ma Yanjun Ma Chenglong Li Chenglong Li Chenglong Li Sijing Wu Qian Ma Wuxiang Xie Wuxiang Xie Wuxiang Xie |
| author_sort | Darui Gao |
| collection | DOAJ |
| description | ObjectiveSeveral clinical trials have indicated that statins stabilize and reverse atherosclerotic plaque. However, different studies have provided inconsistent findings regarding mechanisms and influencing factors of plaque regression under statin therapy. Apart from lipid-lowering effect, statins have pleiotropic effects including anti inflammation in humans. In this study, meta-analysis and meta-regression were used to determine the effects of statin medications on coronary plaque volume. Meanwhile, to assess whether statins promote plaque regression effect was related to their anti-inflammatory ability, the impact of CRP/hsCRP reduction during statin therapy on plaque regression was investigated.MethodsUp to June 15, 2022, a systematic PubMed, EMBASE, and Cochrane search was performed for randomized controlled trials that assessed treatment effect using total atheroma volume (TAV), percent atheroma volume (PAV), or plaque volume (PV). Only CRP/hsCRP and LDL-C values reported before and after treatment were considered.Results12 studies (2,812 patients with heart and/or vascular disease) fulfilled the inclusion criteria and were included in the systematic review. A meta-analysis of 15 statin-treated arms reported a significant reduction in change of TAV/PV [standardized mean difference (SMD): –0.27, 95% confidence intervals (–CI): –0.42, –0.12, p < 0.001], compared with the control arms. Another meta-analysis of 7 trials also found that patients in the intervention group had a significant reduction in change of PAV (SMD: -0.16, 95% CI: –0.29, –0.03, p = 0.019), compared with those in the control group. Meta-regressionanalysis revealed that the percent change of CRP/hsCRP was significantly associated with SMD in change of TAV/PV after adjusting for percent change of LDL-C, age, gender and study duration. Meta-regression analysis showed that percent change of CRP/hsCRP statistically influenced SMD in change of PAV, when percent change of CRP/hsCRP was included separately. However, the percent change of CRP/hsCRP was not significantly associated with SMD of PAV change after adjusting for all covariates.ConclusionIn conclusion, statin therapy is beneficial for plaque regression. Statins promote plaque regression, which might be associated to their anti-inflammatory ability. |
| first_indexed | 2024-04-11T06:59:58Z |
| format | Article |
| id | doaj.art-5a429884882e43e1aab0c9b061598b02 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T06:59:58Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-5a429884882e43e1aab0c9b061598b022022-12-22T04:38:51ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-11-01910.3389/fcvm.2022.989527989527C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trialsDarui Gao0Darui Gao1Darui Gao2Rong Hua3Rong Hua4Rong Hua5Dina Jiesisibieke6Yanjun Ma7Yanjun Ma8Yanjun Ma9Chenglong Li10Chenglong Li11Chenglong Li12Sijing Wu13Qian Ma14Wuxiang Xie15Wuxiang Xie16Wuxiang Xie17Peking University Clinical Research Institute, Peking University First Hospital, Beijing, ChinaPeking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, ChinaKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, ChinaPeking University Clinical Research Institute, Peking University First Hospital, Beijing, ChinaPeking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, ChinaKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, ChinaPeking University Third Hospital, Beijing, ChinaPeking University Clinical Research Institute, Peking University First Hospital, Beijing, ChinaPeking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, ChinaKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, ChinaPeking University Clinical Research Institute, Peking University First Hospital, Beijing, ChinaPeking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, ChinaKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, ChinaDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaPeking University Clinical Research Institute, Peking University First Hospital, Beijing, ChinaPeking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, ChinaKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, ChinaObjectiveSeveral clinical trials have indicated that statins stabilize and reverse atherosclerotic plaque. However, different studies have provided inconsistent findings regarding mechanisms and influencing factors of plaque regression under statin therapy. Apart from lipid-lowering effect, statins have pleiotropic effects including anti inflammation in humans. In this study, meta-analysis and meta-regression were used to determine the effects of statin medications on coronary plaque volume. Meanwhile, to assess whether statins promote plaque regression effect was related to their anti-inflammatory ability, the impact of CRP/hsCRP reduction during statin therapy on plaque regression was investigated.MethodsUp to June 15, 2022, a systematic PubMed, EMBASE, and Cochrane search was performed for randomized controlled trials that assessed treatment effect using total atheroma volume (TAV), percent atheroma volume (PAV), or plaque volume (PV). Only CRP/hsCRP and LDL-C values reported before and after treatment were considered.Results12 studies (2,812 patients with heart and/or vascular disease) fulfilled the inclusion criteria and were included in the systematic review. A meta-analysis of 15 statin-treated arms reported a significant reduction in change of TAV/PV [standardized mean difference (SMD): –0.27, 95% confidence intervals (–CI): –0.42, –0.12, p < 0.001], compared with the control arms. Another meta-analysis of 7 trials also found that patients in the intervention group had a significant reduction in change of PAV (SMD: -0.16, 95% CI: –0.29, –0.03, p = 0.019), compared with those in the control group. Meta-regressionanalysis revealed that the percent change of CRP/hsCRP was significantly associated with SMD in change of TAV/PV after adjusting for percent change of LDL-C, age, gender and study duration. Meta-regression analysis showed that percent change of CRP/hsCRP statistically influenced SMD in change of PAV, when percent change of CRP/hsCRP was included separately. However, the percent change of CRP/hsCRP was not significantly associated with SMD of PAV change after adjusting for all covariates.ConclusionIn conclusion, statin therapy is beneficial for plaque regression. Statins promote plaque regression, which might be associated to their anti-inflammatory ability.https://www.frontiersin.org/articles/10.3389/fcvm.2022.989527/fullstatinsregression of atherosclerosisC-reactive proteinrandomized controlled trialmeta-analysis |
| spellingShingle | Darui Gao Darui Gao Darui Gao Rong Hua Rong Hua Rong Hua Dina Jiesisibieke Yanjun Ma Yanjun Ma Yanjun Ma Chenglong Li Chenglong Li Chenglong Li Sijing Wu Qian Ma Wuxiang Xie Wuxiang Xie Wuxiang Xie C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trials Frontiers in Cardiovascular Medicine statins regression of atherosclerosis C-reactive protein randomized controlled trial meta-analysis |
| title | C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trials |
| title_full | C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trials |
| title_fullStr | C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trials |
| title_full_unstemmed | C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trials |
| title_short | C-reactive protein and coronary atheroma regression following statin therapy: A meta-regression of randomized controlled trials |
| title_sort | c reactive protein and coronary atheroma regression following statin therapy a meta regression of randomized controlled trials |
| topic | statins regression of atherosclerosis C-reactive protein randomized controlled trial meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.989527/full |
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