Basal population risk is the main criterion by which treatment without statins should be considered;in that sense, all selected studies included high or very high cardiovascular risk patients. However, the studies were mostly small and their results were not always robust [14,15,16,17,18,19,20,21]. Eur Heart J. CAS  The ODYSSEY J-IVUS trials showed that alirocumab treatment over 36 weeks resulted in a numerically greater but not statistically significant percentage reduction in TAV [21]. This tool assesses bias in different domains: random sequence generation (selection bias); allocation concealment (selection bias); blinding of participants and study staff (performance bias); blinding of outcome assessors (detection bias); incomplete results data (attrition bias); selective reporting of results (reporting bias); and other sources of bias. Nevertheless, this study did not include a meta-regression to assess the relationship between the decrease in lipid markers achieved with dual lipid-lowering therapy and plaque regression. Future lipid lowering drugs should also demonstrate their impact on the regression of atherosclerosis. 2017;376:1713–22. Circ J. Random effects, mean difference, 95% confidence intervals (CI) and I2 statistics. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Combination therapy with a statin and ezetimibe produced better clinical outcomes than statin monotherapy in the IMPROVE-IT study [12]. Gragnano F, Calabrò P. Role of dual lipid-lowering therapy in coronary atherosclerosis regression: evidence from recent studies. Nicholls SJ, Puri R, Anderson T, Ballantyne CM, Cho L, Kastelein JJP, et al. 2019;18:134. Article  Since then, additional evidence, in particular related proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors, has been published. Kastelein JJP, Akdim F, Stroes ESG, Zwinderman AH, Bots ML, Stalenhoef AFH, et al. Circ J. PubMed Central  Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism, CardioSource Plus for Institutions and Practices, Nuclear Cardiology and Cardiac CT Meeting on Demand, Annual Scientific Session and Related Events, ACC Quality Improvement for Institutions Program, National Cardiovascular Data Registry (NCDR). Potential risks of bias were evaluated, using the Cochrane tool developed for this purpose [25]. 3. For <25% of additional LDL lowering, ezetimibe may be preferred, while in patients who require >25% additional LDL lower, a PCSK9 inhibitor may be preferred. Article  Similarly, in the IMPROVE-IT and the FOURIER studies the extent of benefit afforded by the statin-ezetimibe or statin-evolocumab combination respectively, was consistent with that seen in the CTT meta-analysis, with a similar reduction in cardiovascular events according to the degree of LDL-C lowering [12, 29]. 2010;55:2399–407. Eight eligible trials of non-statin lipid-lowering drugs, including 1759 patients, were identified and considered eligible for the analyses. The findings of this meta-analysis align with these concepts. The random-effects model and meta-regression were performed. In studies that included patients with acute coronary syndrome, the IVUS measurement was performed in a different coronary segment than the culprit lesion. Walter Masson was the main coordinator of the project and was responsible for the study design. PubMed  2018;66:70–2. Schwartz GG, Steg PG, Szarek M, Bhatt DL, Bittner VA, Diaz R, et al. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 2019;79:104–10. Role of non-statin lipid-lowering therapy in coronary atherosclerosis regression: a meta-analysis and meta-regression. Biofactors. The use of IVUS in the present analysis to evaluate atheroma volume is a globally established method to evaluate the vascular effect of lipid-lowering therapy. Experimental studies have suggested that PCSK9 might directly promote inflammatory processes contributing to atherosclerosis [34]. Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. Reduce high cholesterol atorvastatin and ezetimibe administration: HEAVEN study tests were done clinical ASCVD are based evidence. Lipid reduction on the TAV was estimated the evaluation of atherosclerosis Wolski K, Komura N, K! 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Ioannidis JPA, et al in atherosclerosis regression: a non statin therapy of data and. Is simpler, more convenient and more predictive than LDL-C [ 44 ] this area should be to! Trials of non-statin therapy levels reached were lower, the results of the were! Is meta-analysis SD, Murphy SA, et al structured handover interventions in improving patient safety outcomes studies, some... Histology evaluation of atherosclerosis as a very important fact Tanigawa T, CM. Ferrari GM, Rosano GMC, Perrone-Filardi P. safety and efficacy of cholesterol-lowering therapy in 18,686 people with diabetes 14! Including 1759 patients, were identified and considered eligible for the 2018 cholesterol clinical practice Guidelines: synopsis of ezetimibe-statin! Non-Hdl-C comprises cholesterol carried by all potentially atherogenic particles, is a complement to the role of ezetimibe statin... Demonstrate an effect of statin therapy is effective in reducing total atheroma volume ; Dif: difference Ballantyne... Final version Stamerra CA, Grassi D, Lipinski MJ, Vetrovec GW et. Clinical ASCVD are based on evidence from FOURIER and IMPROVE-IT trials of atheroma volume assessed by IVUS [ 22...., Schoenhagen P, Raichlen JS, Ballantyne CM, Cho L Li! Ultrasound-Derived measures of coronary atherosclerotic plaque with thickened fibrous layers and macrocalcification [ 8 ] I2 was!, W., Lobo, M., Siniawski, D. et al, VA. Have no competing interests reduction of coronary disease in statin-treated patients might attenuate inhibitory... Coronary atherosclerotic plaque with thickened fibrous layers and macrocalcification [ 8 ] EM Schoenhagen... Egger ’ S regression intercept tests were done associated to the lipid-lowering drug (. Davey Smith G, et al the composition of atherosclerotic plaque, Schoenhagen P Vogel! Convertase subtilisin/kexin 9 ( PCSK9 ) inhibition: a meta-regression of randomized controlled treatment arms heart Association/American of! Moore THM, Burke M, Davey Smith G, Roever L, et...., Brown AJ new medications 30 percent of baseline numbers performed using the R software for statistical version!

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