Impact of statins based on high-risk plaque features on coronary plaque progression in mild stenosis lesions: results from the PARADIGM study
Authors' conclusion
In mild CAD, statin treatment reduced plaque progression, particularly in lesions with a higher number of HRP features, which was also a strong predictor of rapid plaque progression.
Study context
- Population
- Mild stenosis (25–49%) coronary artery disease (CAD) lesions with serial coronary computed tomography angiography (CCTA); mean age 62.2 years, 63.9% male
- Participants
- 613 participants · 1,432 lesions
- Comparison
- Statin vs no statin, by HRP features
- Primary endpoint
- Annualized percent atheroma volume (PAV) change; rapid progression = ≥90th percentile annual PAV
- Follow-up
- Median inter-scan period 3.5 ± 1.4 years
Methodological detailsprospective observational cohort, serial CCTA, ≥2 year inter-scan interval
- Prospective observational cohort
- Serial CCTA
- ≥2 year inter-scan interval
Primary result
Annual PAV in lesions with ≥2 HRPs
Reduction in annual percent atheroma volume (PAV)
37%
P = 0.038
By group
Statin
0.97
SD 2.02
Non-statin
1.55
SD 2.22
As reported in the abstract
Further findings
Predictors of rapid plaque progression
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| ≥2 HRPs | 1.89 (1.02–3.49) | P = 0.042 | |
| Current smoking | 1.69 (1.09–2.57) | P = 0.017 | |
| Diabetes | 1.55 (1.07–2.22) | P = 0.020 | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Impact of statins based on high-risk plaque features on coronary plaque progression in mild stenosis lesions: results from the PARADIGM study. Eur Heart J Cardiovasc Imaging. Published 26 May 2023. doi:10.
Summarised from the published abstract; every number is checked against it