Highlights
- •Lower LDL-C levels with statins were associated with a lower prevalence of TCFAs.
- •A correlation between LDL-C and TCFAs was observed in patients with lower HbA1c.
- •LDL-C levels <70 mg/dL was independently associated with the lack of TCFAs.
Abstract
Background
Reducing low-density lipoprotein cholesterol (LDL-C) levels with statins slows the
progression of atherosclerotic plaques and reduces cardiovascular events. The 2019
European Society of Cardiology/European Atherosclerosis Society guidelines recommend
absolute LDL-C treatment targets of <100 mg/dL, <70 mg/dL and <55 mg/dL according
to coexisting patient risk factors.
Objective
To clarify the difference in the plaque characteristics of coronary lesions associated
with these LDL-C levels in statin-treated patients.
Methods
A total of 685 consecutive statin-treated patients with coronary artery disease (CAD)
who underwent optical coherence tomography (OCT) imaging of culprit lesions were enrolled.
The characteristics of culprit plaques evaluated by OCT were compared among the high
LDL-C group (≥100 mg/dL, n=247), the moderate LDL-C group (70-100 mg/dL, n=289), the
low LDL-C group (55-70 mg/dL, n=106) and the very low LDL-C group (<55 mg/dL, n=43).
Results
A significant trend toward a lower prevalence of thin-cap fibroatheroma (TCFA) associated
with the LDL-C groups was observed (23.1, 18.3, 9.4 and 11.6%, respectively, in each
group; p=0.002). A trend toward a lower prevalence of TCFAs associated with the LDL-C groups
was also observed among patients with lower hemoglobin A1c (<6.2%; p=0.003). LDL-C <70 mg/dL (the low/very low group) was independently associated with
the lack of TCFAs (odds ratio, 0.50; 95% confidence interval, 0.27-0.87, p=0.014).
Conclusions
Lower LDL-C levels were associated with a lower prevalence of TCFAs in culprit plaques
among statin-treated patients with CAD.
Keywords
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Article info
Publication history
Published online: December 03, 2021
Accepted:
November 27,
2021
Received in revised form:
November 5,
2021
Received:
July 18,
2021
Footnotes
Author contributions: TH: Collecting data, analysis, manuscript writing, YM: Corresponding author, conceiving the project, manuscript writing, KA, MK, AK, AK, TS, YM: Collecting data, analysis, RK, KM, TS: Critical revision of the manuscript, JA: Final approval of manuscript.
Conflict of interest: None.
Disclosures: None.
Identification
Copyright
© 2021 National Lipid Association. Published by Elsevier Inc. All rights reserved.
