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REFLECTIONS dae mia
Dyslipidaemia Global Newsletter #2 Dyslipi
Imaging Plaque Dyslipi
Plaque imaging modalities are broadly differentiated as 1) Non-Invasive aim ead
invasive, including IVUS, OCT, and NIRS, and 2) non-invasive, Invasive
including CCTA, PET, and MRI, with differing resolution, tissue
penetration, and detection capabilities of plaque volume and IVUS CCTA
composition. Gold standard for plaque Can measure volume and
quantification, can assess characterize plaque, assess high risk
Plaque regression strategies can also be broadly categorized morphology with post-processing features, good correlation with IVUS
as 1) dietary and lifestyle; and 2) pharmacological. The
mechanisms of action of the various pharmacological treatments OCT PET
vary from reducing cholesterol deposition (statins, ezetimibe, Higher resolution allows visualization In development, emerging molecular
CETP inhibitors, PCSK9 inhibitors) to reducing cholesterol
inflammation (eicosapentaenoic acid, colchicine). Numerous of thin cap fibroatheroma and lipid imaging probes
studies have demonstrated that achieving lower LDL-C levels content
is associated with lower rates of major adverse CV events. MRI
LDL-C levels also seem to correlate with the degree of plaque NIRS Some success in carotid imaging,
regression, but data assessing whether plaque regression is Semiquantitative lipid measurement ongoing studies to determine use for
directly associated with reduced CV events are limited.
coronary assessment
It is now possible to both induce and detect changes in plaque
volumes and composition through an array of treatments and
imaging techniques. If outcome data linking plaque regression
to reduced CV events emerge, monitoring the response to
coronary plaque treatment may replace surrogate markers such
as risk scores and lipoprotein levels.

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Association between cumulative low-density lipoprotein cholesterol exposure
during young adulthood and middle age and risk of cardiovascular events.

Zhang Y, et al. JAMA Cardiol. 2021 Dec 1;6(12):1406-1413.

Most observational studies on the association between LDL-C and CVD have focused on people in middle or older age, with few
looking at the long-term exposure of LDL-C and their role in CVD risk. The authors of this cohort study analyzed pooled data from
four prospective cohorts in the US, including Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young
Adults Study, Framingham Heart Study Offspring Cohort, and Multi-Ethnic Study of Atherosclerosis to evaluate the association of
cumulative exposure to LDL-C with incident CVD later in life. A total of 18,288 participants were followed-up for a median of 16 years
and 56.4% of participants were women.

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