A cohort study suggested an association of statin use with slower plaque progression and increasing calcium density. The study included 2458 coronary lesions in 857 patients (mean age 62.1 years, 63.0% men, 63.9% received statin therapy) from 2013 to 2016 at 13 sites in 7 countries and had serial quantitative measurements of coronary plaques throughout the entire coronary artery tree. Untreated coronary lesions increased in volume over time for all compositional types. Statin therapy was associated with volume decreases in high-risk low-attenuation and fibro-fatty plaques and greater progression of low-risk high-density calcium and 1K plaques. When analyses were restricted to lesions without the high-risk plaques at baseline, statin therapy was not associated with a change in overall calcified plaque volume but was associated with a transformation toward more dense calcium. Interaction analysis between baseline plaque volume and calcium density showed that more dense coronary calcium was associated with less plaque progression. The results suggest an association of statin use with greater rates of transformation of coronary plaques toward high-density calcium, supporting previous study of reduced atherosclerotic risk with high density plaques. Source: https://jamanetwork.com/
