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Effect of Statin Therapy on Arterial Wall Inflammation Based on 18F-FDG PET/CT: A Systematic Review and Meta-Analysis of Interventional Studies.

Abstract：

:Aim. To evaluate by meta-analysis of interventional studies the effect of statin therapy on arterial wall inflammation. Background. Arterial exposure to low-density lipoprotein (LDL) cholesterol levels is responsible for initiation and progression of atherosclerosis and arterial wall inflammation. 18F-fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (18F-FDG PET/CT) has been used to detect arterial wall inflammation and monitor the vascular anti-inflammatory effects of lipid-lowering therapy. Despite a number of statin-based interventional studies exploring 18F-FDG uptake, these trials have produced inconsistent results. Methods. Trials with at least one statin treatment arm were searched in PubMed-Medline, SCOPUS, ISI Web of Knowledge, and Google Scholar databases. Target-to-background ratio (TBR), an indicator of blood-corrected 18F-FDG uptake, was used as the target variable of the statin anti-inflammatory activity. Evaluation of studies biases, a random-effects model with generic inverse variance weighting, and sensitivity analysis were performed for qualitative and quantitative data assessment and synthesis. Subgroup and meta-regression analyses were also performed. Results. Meta-analysis of seven eligible studies, comprising 10 treatment arms with 287 subjects showed a significant reduction of TBR following statin treatment (Weighted Mean Difference (WMD): -0.104, p = 0.002), which was consistent both in high-intensity (WMD: -0.132, p = 0.019) and low-to-moderate intensity statin trials (WMD: -0.069, p = 0.037). Statin dose/duration, plasma cholesterol and C-reactive protein level changes, and baseline TBR did not affect the TBR treatment response to statins. Conclusions. Statins were effective in reducing arterial wall inflammation, as assessed by 18F-FDG PET/CT imaging. Larger clinical trials should clarify whether either cholesterol-lowering or other pleiotropic mechanisms were responsible for this effect.

journal_name

J Clin Med

journal_title

Journal of clinical medicine

authors

Pirro M,Simental-Mendía LE,Bianconi V,Watts GF,Banach M,Sahebkar A

doi

10.3390/jcm8010118

subject

Has Abstract

pub_date

2019-01-18 00:00:00

issue

issn

2077-0383

pii

jcm8010118

journal_volume

pub_type

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Effect of Statin Therapy on Arterial Wall Inflammation Based on 18F-FDG PET/CT: A Systematic Review and Meta-Analysis of Interventional Studies.