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. 2024 Dec 18;21(1):52.
doi: 10.1186/s12950-024-00421-x.

Effect of statins on arterial wall inflammation as assessed by 18F-FDG PET CT: an updated systematic review and meta-analysis

Tannaz Jamialahmadi  1   2 , Željko Reiner  3   4 , Luis E Simental-Mendia  5 , Wael Almahmeed  6 , Sercan Karav  7 , Ali H Eid  8 , Francesco Giammarile  9 , Amirhossein Sahebkar  10   11   12
Affiliations

Effect of statins on arterial wall inflammation as assessed by 18F-FDG PET CT: an updated systematic review and meta-analysis

Tannaz Jamialahmadi et al. J Inflamm (Lond). .

Abstract

Background: Pathogenesis of atherosclerosis is largely mediated by inflammatory process. Statins are lipid-lowering drugs which also have anti-inflammatory effects. 18 fluorine radiolabeled fluorodeoxyglucose (18 F-FDG) positron emission tomography-computed tomography (PET-CT) is considered to be a good indicator of arterial wall inflammation. Therefore, in this meta-analysis the role of statins on inflammatory process in the artery wall was evaluated using this method since its actual validity for this purpose is not yet well established.

Methods: PubMed, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar databases were searched using MESH terms and keywords. Funnel plot, Begg's rank correlation, and Egger's weighted regression tests evaluated publication bias in the meta-analysis. In cases where funnel plot asymmetry was observed, the "trim and fill" method was used to check the input of potentially missing studies.

Results: Findings of 10 clinical trials involving 373 subjects showed a remarkable reduction of arterial wall 18 F-FDG uptake according to target-to-background ratio (TBR) index after treatment with statins. Subgroup analysis showed a significant decrease in TBR with high-intensity and non-significant reduction of TBR with low-to-moderate-intensity statin therapy.

Conclusion: Treatment with statins suppressed arterial wall inflammation as shown by using 18 F-FDG PET-CT.

Keywords: 18F-FDG PET-CT; Atherosclerosis; Cardiovascular disease; Inflammation; Statins.

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Conflict of interest statement

Declarations. Ethical approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the number of studies selected for meta-analysis
Fig. 2
Fig. 2
Quantitative Data Synthesis (arterial wall uptake). A Effect of statin therapy on arterial wall FDG uptake. Forest plot shows weighted mean difference (WMD) and 95% confidence intervals for the effect of statin administration on arterial wall FDG uptake based on whole vessel TBR index. 2 B leave-one-out sensitivity analysis
Fig. 3
Fig. 3
Effect of statin therapy on FDG uptake of the most diseased arterial segment (MDS). Forest plot displays weighted mean difference (WMD) and 95% confidence intervals for the effect of statin administration on arterial wall FDG uptake based on the MDS of vessel TBR
Fig. 4
Fig. 4
Forest plot stratified according to the intensity of statin therapy
Fig. 5
Fig. 5
The results of meta-regression analyses examining the associations between different potential confounders and changes in arterial wall TBR. The analysis investigated the relationship between (A) treatment duration, (B) alteration in circulating LDL-cholesterol, (C) plasma levels of C-reactive protein, (D) baseline TBR, and mean changes in arterial wall TBR index
Fig. 6
Fig. 6
Funnel plot showing publication bias in the studies
See this image and copyright information in PMC

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