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. 2024 Apr 12;45(20):1783–1800. doi: 10.1093/eurheartj/ehae190

Table 3.

Studies investigating effect of medication on coronary computed tomography angiography-defined atherosclerosis progression

Intervention Main inclusion criterion Sample size Duration of follow-up Effect on plaque morphology
Statins90 Suspected or known coronary artery disease 857 patients with 2458 coronary lesions 3.6 years

  • Reductions in low-attenuation plaque (β = −0.02; P = .001) and fibro-fatty plaque (β = −0.03; P < .001)

  • No change in fibrous plaque and low-density calcium

  • Increase in high-density calcium and 1 K plaque
Atorvastatin80 HIV 19 patients receiving atorvastatin
21 patients receiving placebo		 12 months

  • Reduction in non-calcified plaque volume compared to placebo (−19.4% vs. 20.4%; P = .009)

  • Reduction in number of high-risk plaques compared to placebo
Pitavastatin81 HIV 402 patients receiving pitavastatin
402 patients receiving placebo		 2 years

  • Reduction in non-calcified plaque compared to placebo (−1.7 mm3 vs. 2.6 mm3; P = .044)

  • 33% relative reduction in non-calcified plaque progression
PCSK9 inhibition85 Presence of vulnerable plaque 98 patients with 136 vulnerable plaques (lesions with HU < 50) 6 months

  • Increase in minimal Hounsfield Unit value (39.1 ± 8.1 HU to 84.9 ± 31.4 HU, P < .001)

  • Reduction in remodelling index (1.29 ± 0.11 to 1.19 ± 0.10, P < .001)
Icosapent ethyl86,87,89 CAD and elevated triglyceride levels 31 patients receiving icosapent ethyl
37 receiving placebo		 18 months

  • Reduction in low-attenuation (−17%; P = .0061), fibro-fatty (−34%; P = .0002), and fibrous plaque (−20%; P = .0028)

  • Significant benefits in coronary physiology as assessed by change in fractional flow reserve

  • No change in calcified plaque
Colchicine88 Recent ACS <1 month 40 patients receiving colchicine
40 controls		 13 months

  • Reduction in low-attenuation plaque volume (15.9 mm3 vs. 6.6 mm3; P = .008)

  • No reduction in total plaque progression
Diet intervention91 Non-obstructive CAD (<70%) 45 in diet intervention
44 controls		 15 months

  • Reduction in non-calcified plaque compared to placebo (−51.3 mm3 vs. −21.3 mm3; P = .045)

  • No reduction in total or calcified plaque progression

ACS, acute coronary syndrome; CAD, coronary artery disease; HIV, human immunodeficiency virus; PCSK9, proprotein convertase subtilisin-kexin type 9.