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What We Have Learned from the Recent Meta-analyses on Diagnostic Methods for Atherosclerotic Plaque Regression

  • Evidence-Based Medicine (L. Roever, Section Editor)
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Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Atherosclerosis has major morbidity and mortality implications globally. While it has often been considered an irreversible degenerative process, recent evidence provides compelling proof that atherosclerosis can be reversed. Plaque regression is however difficult to appraise and quantify, with competing diagnostic methods available. Given the potential of evidence synthesis to provide clinical guidance, we aimed to review recent meta-analyses on diagnostic methods for atherosclerotic plaque regression.

Recent Findings

We identified 8 meta-analyses published between 2015 and 2017, including 79 studies and 14,442 patients, followed for a median of 12 months. They reported on atherosclerotic plaque regression appraised with carotid duplex ultrasound, coronary computed tomography, carotid magnetic resonance, coronary intravascular ultrasound, and coronary optical coherence tomography. Overall, all meta-analyses showed significant atherosclerotic plaque regression with lipid-lowering therapy, with the most notable effects on echogenicity, lipid-rich necrotic core volume, wall/plaque volume, dense calcium volume, and fibrous cap thickness. Significant interactions were found with concomitant changes in low density lipoprotein cholesterol, high density lipoprotein cholesterol, and C-reactive protein levels, and with ethnicity.

Summary

Atherosclerotic plaque regression and conversion to a stable phenotype is possible with intensive medical therapy and can be demonstrated in patients using a variety of non-invasive and invasive imaging modalities.

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Authors and Affiliations

  1. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100, Latina, Italy

    Giuseppe Biondi-Zoccai, Simona Mastrangeli, Mariangela Peruzzi & Giacomo Frati

  2. Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy

    Giuseppe Biondi-Zoccai & Giacomo Frati

  3. Division of Cardiology, S. Giovanni Hospital, Rome, Italy

    Enrico Romagnoli

  4. Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil

    Leonardo Roever

  5. Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy

    Arturo Giordano

  6. Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy

    Arturo Giordano

Authors
  1. Giuseppe Biondi-Zoccai
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  2. Simona Mastrangeli
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  3. Enrico Romagnoli
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  4. Mariangela Peruzzi
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  5. Giacomo Frati
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  6. Leonardo Roever
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  7. Arturo Giordano
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Correspondence to Giuseppe Biondi-Zoccai.

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Conflict of Interest

Simona Mastrangeli, Enrico Romagnoli, Mariangela Peruzzi, Giacomo Frati, Leonardo Roever, and Arturo Giordano declare no conflict of interest. Prof. Biondi-Zoccai has consulted for Abbott Vascular and Bayer.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Evidence-Based Medicine

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Biondi-Zoccai, G., Mastrangeli, S., Romagnoli, E. et al. What We Have Learned from the Recent Meta-analyses on Diagnostic Methods for Atherosclerotic Plaque Regression. Curr Atheroscler Rep 20, 2 (2018). https://doi.org/10.1007/s11883-018-0709-y

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