Early decrease in carotid plaque lipid content as assessed by magnetic resonance imaging during treatment of...

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Medical Imaging

Background:

• Statin therapy is known to reduce lipid content in atherosclerotic plaques and promote regression.
• The precise timing of plaque lipid depletion following low-density lipoprotein cholesterol (LDL-C) lowering in vivo remains incompletely understood.
• Early detection of plaque changes is crucial for understanding therapeutic efficacy.

Purpose of the Study:

• To investigate the early effects of rosuvastatin on carotid plaque lipid content in statin-naïve patients.
• To determine the time course of lipid-rich necrotic core (LRNC) volume changes following LDL-C reduction.
• To assess plaque burden modifications during statin treatment.

Main Methods:

• 43 lipid treatment-naïve subjects with asymptomatic carotid atherosclerosis and LDL-C between 100-250 mg/dl were enrolled.
• Rosuvastatin (5-20 mg/day) was administered to achieve LDL-C levels below 80 mg/dl.
• Carotid MRI scans and lipid profiles were obtained at baseline and at 3, 12, and 24 months to measure LRNC volume and plaque burden.

Main Results:

• At 3 months, rosuvastatin (average 11 mg/day) reduced LDL-C by 47% (p < 0.001).
• A significant decrease in LRNC volume (7.3%, p = 0.044) and % LRNC (p = 0.02) was observed at 3 months.
• No significant changes in total wall, percent wall, or lumen volume were detected at 3 months, though LRNC continued to decrease moderately up to 24 months.

Conclusions:

• Rosuvastatin therapy can induce a rapid and sustained reduction in carotid plaque lipid content.
• The findings suggest that early lipid depletion in atherosclerotic plaques is achievable with statin treatment.
• Carotid MRI is a valuable tool for assessing these early plaque modifications.