Simvastatin attenuates plaque inflammation : Evaluation by fluorodeoxyglucose positron emission tomography

• Published in: Journal of the American College of Cardiology Vol. 48; no. 9; pp. 1825 - 1831
• Main Authors: TAHARA, Nobuhiro, KAI, Hisashi, ISHIBASHI, Masatoshi, NAKAURA, Hiroyuki, KAIDA, Hayato, BABA, Kenkichi, HAYABUCHI, Naofumi, IMAIZUMI, Tsutomu
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Science 07.11.2006; Elsevier Limited
• Subjects: Aged; Aorta, Thoracic - diagnostic imaging; Aorta, Thoracic - pathology; Atherosclerosis; Atherosclerosis - diagnostic imaging; Atherosclerosis - drug therapy; Atherosclerosis - pathology; Biological and medical sciences; Blood pressure; Body mass index; Cardiology; Cardiology. Vascular system; Cardiovascular disease; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - drug therapy; Carotid Stenosis - pathology; Cholesterol; Diabetes; Drug dosages; Enzymes; Female; Fluorodeoxyglucose F18; Follow-Up Studies; Glucose; Humans; Hypertension; Inflammation - diagnostic imaging; Inflammation - drug therapy; Lipids; Lipoproteins; Male; Medical sciences; Medical screening; Middle Aged; Mortality; Plasma; Positron-Emission Tomography - methods; Prospective Studies; Simvastatin - therapeutic use; Statins; Studies; Triglycerides; Japan; Radionuclide study; Evaluation; Simvastatin; Inflammation; Circulatory system; Cardiology; Phlebology; Positron emission tomography; Emission tomography
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2006.03.069

We investigated whether simvastatin attenuates plaque inflammation by using 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) co-registered with computerized tomography. Inflammation plays a key role in progression and destabilization of atherosclerotic plaque. 18F-fluorodeoxyglucose PET is a promising tool for visualizing inflammation of atherosclerotic plaque. Antiinflammatory action is one of the pleiotropic effects of statins. Forty-three consecutive subjects, who underwent 18FDG-PET for cancer screening and had 18FDG uptakes in the thoracic aorta and/or the carotid arteries, were randomized to either statin group receiving simvastatin (n = 21) or diet group receiving dietary management only (n = 22). The maximum standardized uptake values (SUVs) were measured in individual plaques, and were averaged for analysis of the subjectwise results. The responses were assessed after 3-month treatments. Positron emission tomography revealed 117 and 123 18FDG-positive plaques in the statin and diet groups, respectively. Simvastatin, but not diet alone, attenuated plaque (18)FDG uptakes and decreased the SUVs (p < 0.01). Simvastatin reduced low-density lipoprotein cholesterol (LDL-C) by 30% (p < 0.01) and increased high-density lipoprotein cholesterol (HDL-C) by 15% (p < 0.01), whereas LDL-C and HDL-C levels were not changed in the diet group. In the statin group, the decrease in the SUV was well correlated with the HDL-C elevation (p < 0.01) but not with the LDL-C reduction. 18F-fluorodeoxyglucose PET visualized plaque inflammation and simvastatin attenuated it. The LDL-C-independent effects of simvastatin may participate in the beneficial effect. 18F-fluorodeoxyglucose PET has a potential for visually monitoring plaque inflammation and the therapeutic effectiveness of statins.