The International Journal of Cardiovascular Imaging

, Volume 35, Issue 9, pp 1745–1753 | Cite as

Anti-inflammatory effect of statin is continuously working throughout use: a prospective three time point 18F-FDG PET/CT imaging study

  • Min-Kyu Kang
  • Chan Joon Kim
  • Eun-Ho Choo
  • Eun Ji Han
  • Byung-Hee Hwang
  • Jin-Jin Kim
  • Sung Hoon Kim
  • Joo Hyun O
  • Kiyuk ChangEmail author
Original Paper


No data exist whether statins have robust anti-inflammatory effects of atherosclerotic plaques primarily during the early treatment period or continuously throughout use. This prospective three time point 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) study of the carotid artery assessed anti-inflammatory effects of statin during the early treatment period (initiation to 3 months) and late treatment period (3 months to 1 year) and their correlation with lipid and inflammatory profile changes during a year of therapy. Nine statin-naïve stable angina patients with inflammatory carotid plaques received 20 mg/day atorvastatin after undergoing initial 18F-FDG PET/CT scanning of carotid arteries and ascending thoracic aorta, and then completed serial 18F-FDG PET/CT imaging at 3 and 12 months whose data were analyzed. The primary outcome was the inter-scan percent change in target-to-background ratio (ΔTBR) within the index vessel. At 3 months of atorvastatin treatment, mean serum low-density lipoprotein cholesterol (LDL-C) level decreased by 36.4% to < 70 mg/dL (p = 0.001) and mean serum high-density lipoprotein cholesterol level increased to > 40 mg/dL (p = 0.041), with both maintained with no further reduction up to 1 year (p = 0.516 and 0.715, respectively) while mean serum high sensitivity C-reactive protein level only numerically decreased (p = 0.093). The index vessel ΔTBR showed continuous plaque inflammation reduction over 1 year, by 4.4% (p = 0.015) from the initiation to 3rd months and 6.2% (p = 0.009) from 3rd months to 1 year, respectively, without correlation with lipid profile changes. The ΔTBR of the bilateral carotid arteries and ascending aorta also continuously decreased from 3 months to 1 year. Three time point 18F-FDG PET/CT imaging demonstrates that statin’s anti-inflammatory effect continues throughout its use up to 1 year, even though yielding stable below-target plasma LDL-C levels at 3 months.


Statin 18F-FDG PET/CT Low-density lipoprotein cholesterol 



F-18 fluorine fluorodeoxyglucose


High-density lipoprotein cholesterol


High sensitivity C-reactive protein


Low-density lipoprotein cholesterol




Most diseased segment


Magnetic resonance imaging


Positron emission tomography/computed tomography


Region of interest


Maximum standardized uptake value


Target to background ratio



This study was supported by a Grant from the Korea Healthcare Technology R&D Project, Ministry for Health and Welfare, Republic of Korea (A070001).

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interests.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Cardiology Division, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  2. 2.Cardiology Division, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaUijoenbu-siRepublic of Korea
  3. 3.Department of Radiology, Daejeon St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaDaejeonRepublic of Korea
  4. 4.Department of Radiology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea

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