Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment

Background: this study aimed to determine the relationship of statin therapy and cardiovascular risk factors to changes in atherosclerosis in the carotid artery.methods and results: carotid magnetic resonance imaging was used to evaluate 106 hyperlipidemic participants at baseline and after 12 months of 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitor (statin) treatment. multivariable logistic regression was used to determine factors associated with progression (change in carotid wall volume >0) or regression (change ≤0) of carotid atherosclerosis. computed tomography coronary calcium scores were obtained at baseline for all participants. the median age was 65 years (interquartile range 60-69 years),and 63% of the participants were male. body mass index >30,elevated c-reactive protein,and hypertension were associated with increased carotid wall volume (obesity: odds ratio for progression 4.6,95% ci 1.8-12.4,p<0.01; c-reactive protein: odds ratio for progression 2.56,95% ci 1.17-5.73,p=0.02; hypertension: odds ratio 2.4,95% ci 1.1-5.3,p<0.05). higher statin dose was associated with regression of carotid wall volume (p<0.05). in multivariable analysis,obesity remained associated with progression (p<0.01),whereas statin use remained associated with regression (p<0.05). change in atheroma volume in obese participants was +4.8% versus -4.2% in nonobese participants (p<0.05) despite greater low-density lipoprotein cholesterol reduction in obese participants.conclusions: in a population with hyperlipidemia,obese patients showed atheroma progression despite optimized statin therapy.clinical trial registration: url: http://www.clinicaltrials.gov. unique identifier: nct01212900. © 2016 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.