Intravascular ultrasound (IVUS) may be useful for assessing the effects of statins on regression and progression of coronary artery plaque, researchers from Japan report.
The findings don't mean patients should all be monitored in this way; it's obviously invasive, and most insurance companies consider this indication to be investigational.
But as lead author Dr. Hideaki Kaneda from Okinaka Memorial Institute for Medical Research and Tokyo Heart Center, Tokyo, told Reuters Health by e-mail, "current resolution of CT/MRI is not enough to determine plaque volume accurately (and) although optical coherence tomography has higher resolution, its penetration depth is not enough to determine vessel size/plaque volume."
Dr. Kaneda and colleagues reviewed 26 studies (with a total of 5,794 patients) of IVUS in patients taking statins (11 studies), antihypertensive drugs (3 studies), antidiabetic drugs (3), drugs modifying HDL (3), lipid-lowering drugs other than statins (2), antioxidants (2), antiobesity drugs (1), and other drugs (1).
They focused on three commonly used IVUS variables: (1) absolute or nominal change in plaque or atheroma volume, (2) percentage change in plaque or atheroma volume, and (3) absolute or nominal change in percentage plaque or atheroma volume.
There were significant differences between statin-treated and control groups in only eight of 20 studies reporting nominal changes in plaque volume, four of 11 studies reporting percentage change in plaque volume, and three of 10 studies reporting nominal changes in percent plaque volume, according to their October 26 online report in the American Journal of Cardiology.
Fewer than half of the examined variables showed statistically significant differences in comparing groups, and results were more often significant when shorter segments (<10 mm) were analyzed.
"Current methods of calculating plaque volume using IVUS have several limitations," Dr. Kaneda told Reuters Health by e-mail. "In addition, it remains unknown whether IVUS variables (change of plaque volume) are valid surrogate markers that examine the effects of drugs other than statin."
"Less invasive imaging modalities with high resolution are needed," Dr. Kaneda concluded.
By Will Boggs, MD
Source: http://link.reuters
Article Published in :Am J Cardiology
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