Anja Judith Reimann MD, Presenter: Nothing to Disclose

Christof Burgstahler MD, Abstract Co-Author: Nothing to Disclose

Martin Heuschmid MD, Abstract Co-Author: Nothing to Disclose

Andreas F. Kopp MD, Abstract Co-Author: Nothing to Disclose

Stephen Schroeder MD, Abstract Co-Author: Nothing to Disclose

Marc Schmit MD, Abstract Co-Author: Nothing to Disclose

Hyperlipoproteinemia is one important risk factor for coronary atherosclerosis. Treatment of elevated lipid levels has shown to reduce mortality in patient with coronary artery disease (CAD) and multi-slice computed tomography is a non-invasive modality to detect and classify coronary plaques. The aim of the present study was to detect coronary lesions in male persons without established CAD but with an increased risk for disease, as well as to assess the effect of a lipid lowering therapy (LLT) with 20 mg atorvastatin in a follow-up scan.

46 male patients (pts) (61±10 years) with an elevated risk for CAD (PROCAM score > 3. percentile) and/or atypical chest pain without lipid lowering therapy were included in this study. After a native scan to assess calcium burden, contrast-enhanced scans were performed in all pts. 27/46 pts received a follow-up scan (2. scan after 488 ± 138 days, LLT in 20/27 pts). Coronary plaque burden was assessed on coronary cross sectional slices volumetrically.

Patients with LLT (n=20): Total cholesterol and LDL-cholesterol levels decreased significantly under LLT (225 ± 41 mg/dl vs. 162 ± 37 mg/dl, p0.05), whereas mean plaque volume of non-calcified plaques decreased significantly from 0.042 ± 0.029 mL to 0.030 ± 0.014 mL (p<0.05, mean reduction 0.012 ± 0.017 mL or 24 ± 13%). Patients without LLT (n=7): Total cholesterol remained unchanged (214 ± 64 mg/dl vs. 230 ± 62 mg/dl).

For the first time the influence of a lipid lowering therapy on coronary plaque burden could be assessed non-invasively by MSCT. Lipid lowering therapy with 20 mg atorvastatin/die lead to a significant reduction of non-calcified plaque burden. This was not reflected in calcium scoring or total plaque burden. Thus, contrast application to visualize non-calcified coronary plaques is mandatory to assess these changes.

MSCT has the potential to monitor medical treatment in patients with coronary atherosclerosis.

Reimann, A, Burgstahler, C, Heuschmid, M, Kopp, A, Schroeder, S, Schmit, M, Influence of a Lipid Lowering Therapy on Coronary Atherosclerosis in Persons with an Elevated Risk for an Acute Coronary Event Assessed by Multislice Computed Tomography.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4428293.html