Atherosclerotic Coronary Plaque Regression and Risk of Adverse Cardiovascular Events: A Systematic Review and Updated Meta-Regression Analysis
Authors' conclusion
In this meta-analysis, regression of atherosclerotic plaque by 1% was associated with a 25% reduction in the odds of MACEs.
Study context
- Population
- Clinical prospective studies of lipid-lowering therapies reporting IVUS percent atheroma volume (PAV) change and MACE components, published July 2001–July 2022
- Participants
- 7,407 participants · 23 studies
- Comparison
- Change in PAV and MACE
- Outcome
- Association between mean PAV change and MACE
Methodological detailsmixed-effects 2-level binomial logistic regression
- Mixed-effects 2-level binomial logistic regression
Pooled result
As reported in the abstract
MACE per 1% decrease in PAV (meta-regression)
Estimate (95% CI)P value
1% decrease in mean PAVunadjusted
unadjusted OR 0.83(0.71–0.98)
P = 0.031% decrease in mean PAVadjusted for clinical covariates
adjusted OR 0.86(0.75–1.00)
P = 0.0501% decrease in PAVfurther adjusted for CV risk factors
adjusted OR 0.81(0.68–0.96)
P = 0.011% reduction of PAV change between intervention and comparator arms within studieswithin-study
OR 0.75(0.56–1.00)
P = 0.046Per 1% decrease in PAV, as printed
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| MACE per 1% reduction of PAV change between intervention and comparator arms within studies | 0.75 (0.56–1.00) | P = 0.046 | |
| 0.512Odds ratio (log scale) |
Change in PAV across 46 study arms
- Range of PAV change
- −5.6% to 3.1%
- Major adverse cardiovascular events (MACEs) per study arm
- 0 to 72
Original publication
Atherosclerotic Coronary Plaque Regression and Risk of Adverse Cardiovascular Events: A Systematic Review and Updated Meta-Regression Analysis. JAMA Cardiol. Published 1 October 2023. doi:10.
Summarised from the published abstract; every number is checked against it