Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study
Nonobstructive coronary plaques manifesting high-risk morphology (HRM) associate with an increased risk of adverse clinical cardiovascular events. We sought to test the hypothesis that statins have a greater anti-inflammatory effect within coronary plaques containing HRM. In this prospective multice...
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| Veröffentlicht in: | Circulation. Cardiovascular imaging 2016-12, Vol.9 (12) |
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| creator | Singh, Parmanand Emami, Hamed Subramanian, Sharath Maurovich-Horvat, Pal Marincheva-Savcheva, Gergana Medina, Hector M Abdelbaky, Amr Alon, Achilles Shankar, Sudha S Rudd, James H F Fayad, Zahi A Hoffmann, Udo Tawakol, Ahmed |
| description | Nonobstructive coronary plaques manifesting high-risk morphology (HRM) associate with an increased risk of adverse clinical cardiovascular events. We sought to test the hypothesis that statins have a greater anti-inflammatory effect within coronary plaques containing HRM.
In this prospective multicenter study, 55 subjects with or at high risk for atherosclerosis underwent
F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and after 12 weeks of treatment with atorvastatin. Coronary arterial inflammation (
F-fluorodeoxyglucose uptake, expressed as target-to-background ratio) was assessed in the left main coronary artery (LMCA). While blinded to the PET findings, contrast-enhanced computed tomographic angiography was performed to characterize the presence of HRM (defined as noncalcified or partially calcified plaques) in the LMCA. Arterial inflammation (target-to-background ratio) was higher in LMCA segments with HRM than those without HRM (mean±SEM: 1.95±0.43 versus 1.67±0.32 for LMCA with versus without HRM, respectively; P=0.04). Moreover, atorvastatin treatment for 12 weeks reduced target-to-background ratio more in LMCA segments with HRM than those without HRM (12 week-baseline Δtarget-to-background ratio [95% confidence interval]: -0.18 [-0.35 to -0.004] versus 0.09 [-0.06 to 0.26]; P=0.02). Furthermore, this relationship between coronary plaque morphology and change in LMCA inflammatory activity remained significant after adjusting for baseline low-density lipoprotein and statin dose (β=-0.27; P=0.038).
In this first study to evaluate the impact of statins on coronary inflammation, we observed that the anti-inflammatory impact of statins is substantially greater within coronary plaques that contain HRM features. These findings suggest an additional mechanism by which statins disproportionately benefit individuals with more advanced atherosclerotic disease.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00703261. |
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In this prospective multicenter study, 55 subjects with or at high risk for atherosclerosis underwent
F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and after 12 weeks of treatment with atorvastatin. Coronary arterial inflammation (
F-fluorodeoxyglucose uptake, expressed as target-to-background ratio) was assessed in the left main coronary artery (LMCA). While blinded to the PET findings, contrast-enhanced computed tomographic angiography was performed to characterize the presence of HRM (defined as noncalcified or partially calcified plaques) in the LMCA. Arterial inflammation (target-to-background ratio) was higher in LMCA segments with HRM than those without HRM (mean±SEM: 1.95±0.43 versus 1.67±0.32 for LMCA with versus without HRM, respectively; P=0.04). Moreover, atorvastatin treatment for 12 weeks reduced target-to-background ratio more in LMCA segments with HRM than those without HRM (12 week-baseline Δtarget-to-background ratio [95% confidence interval]: -0.18 [-0.35 to -0.004] versus 0.09 [-0.06 to 0.26]; P=0.02). Furthermore, this relationship between coronary plaque morphology and change in LMCA inflammatory activity remained significant after adjusting for baseline low-density lipoprotein and statin dose (β=-0.27; P=0.038).
In this first study to evaluate the impact of statins on coronary inflammation, we observed that the anti-inflammatory impact of statins is substantially greater within coronary plaques that contain HRM features. These findings suggest an additional mechanism by which statins disproportionately benefit individuals with more advanced atherosclerotic disease.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00703261.</description><identifier>EISSN: 1942-0080</identifier><identifier>PMID: 27956407</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Anti-Inflammatory Agents - therapeutic use ; Atorvastatin - therapeutic use ; Biomarkers - blood ; Computed Tomography Angiography ; Coronary Angiography - methods ; Coronary Artery Disease - blood ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - drug therapy ; Coronary Vessels - diagnostic imaging ; Coronary Vessels - drug effects ; Double-Blind Method ; Female ; Fluorodeoxyglucose F18 - administration & dosage ; Humans ; Inflammation Mediators - blood ; Male ; Middle Aged ; Plaque, Atherosclerotic ; Positron Emission Tomography Computed Tomography ; Predictive Value of Tests ; Prospective Studies ; Radiopharmaceuticals - administration & dosage ; Risk Factors ; Severity of Illness Index ; Time Factors ; Treatment Outcome ; United States ; Vascular Calcification - diagnostic imaging ; Vascular Calcification - drug therapy</subject><ispartof>Circulation. Cardiovascular imaging, 2016-12, Vol.9 (12)</ispartof><rights>2016 The Authors.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27956407$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Singh, Parmanand</creatorcontrib><creatorcontrib>Emami, Hamed</creatorcontrib><creatorcontrib>Subramanian, Sharath</creatorcontrib><creatorcontrib>Maurovich-Horvat, Pal</creatorcontrib><creatorcontrib>Marincheva-Savcheva, Gergana</creatorcontrib><creatorcontrib>Medina, Hector M</creatorcontrib><creatorcontrib>Abdelbaky, Amr</creatorcontrib><creatorcontrib>Alon, Achilles</creatorcontrib><creatorcontrib>Shankar, Sudha S</creatorcontrib><creatorcontrib>Rudd, James H F</creatorcontrib><creatorcontrib>Fayad, Zahi A</creatorcontrib><creatorcontrib>Hoffmann, Udo</creatorcontrib><creatorcontrib>Tawakol, Ahmed</creatorcontrib><title>Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study</title><title>Circulation. Cardiovascular imaging</title><addtitle>Circ Cardiovasc Imaging</addtitle><description>Nonobstructive coronary plaques manifesting high-risk morphology (HRM) associate with an increased risk of adverse clinical cardiovascular events. We sought to test the hypothesis that statins have a greater anti-inflammatory effect within coronary plaques containing HRM.
In this prospective multicenter study, 55 subjects with or at high risk for atherosclerosis underwent
F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and after 12 weeks of treatment with atorvastatin. Coronary arterial inflammation (
F-fluorodeoxyglucose uptake, expressed as target-to-background ratio) was assessed in the left main coronary artery (LMCA). While blinded to the PET findings, contrast-enhanced computed tomographic angiography was performed to characterize the presence of HRM (defined as noncalcified or partially calcified plaques) in the LMCA. Arterial inflammation (target-to-background ratio) was higher in LMCA segments with HRM than those without HRM (mean±SEM: 1.95±0.43 versus 1.67±0.32 for LMCA with versus without HRM, respectively; P=0.04). Moreover, atorvastatin treatment for 12 weeks reduced target-to-background ratio more in LMCA segments with HRM than those without HRM (12 week-baseline Δtarget-to-background ratio [95% confidence interval]: -0.18 [-0.35 to -0.004] versus 0.09 [-0.06 to 0.26]; P=0.02). Furthermore, this relationship between coronary plaque morphology and change in LMCA inflammatory activity remained significant after adjusting for baseline low-density lipoprotein and statin dose (β=-0.27; P=0.038).
In this first study to evaluate the impact of statins on coronary inflammation, we observed that the anti-inflammatory impact of statins is substantially greater within coronary plaques that contain HRM features. These findings suggest an additional mechanism by which statins disproportionately benefit individuals with more advanced atherosclerotic disease.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00703261.</description><subject>Adult</subject><subject>Aged</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Atorvastatin - therapeutic use</subject><subject>Biomarkers - blood</subject><subject>Computed Tomography Angiography</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - drug therapy</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Coronary Vessels - drug effects</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18 - administration & dosage</subject><subject>Humans</subject><subject>Inflammation Mediators - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Plaque, Atherosclerotic</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Radiopharmaceuticals - administration & dosage</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>United States</subject><subject>Vascular Calcification - diagnostic imaging</subject><subject>Vascular Calcification - drug therapy</subject><issn>1942-0080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkOFKwzAUhYMgbk5fQfICxaRpk9R_pWxa2HDg_D3SJt0iTVObROwr-ZQGVPDXuefcyz3wXYAlLrI0QYijBbh27g0hSlDOr8AiZUVOM8SW4Kuykx3ENMN9L96Dgjs7jWfb29MMxSChPytYDl4n9dD1whjhbbytzShaD20Hy-g_hPPC6-EBlnAXeq9bNXg1Qcw3yaYPsUAq-zmf-tBap-DeOu1jKVwb7ZyOw8Eae5rEeNbtfWXNGLyS_0P44oOcb8BlJ3qnbn91BV4360P1lGyfH-uq3CYjTqlPiqzpGGspw1xigigjqKUyz7M0blDOhCxwTgnJqKQ5Zp1seUObrpC8KzhBgqzA3c_fMTRGyeM4aRMBHf-gkW-_5GuZ</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Singh, Parmanand</creator><creator>Emami, Hamed</creator><creator>Subramanian, Sharath</creator><creator>Maurovich-Horvat, Pal</creator><creator>Marincheva-Savcheva, Gergana</creator><creator>Medina, Hector M</creator><creator>Abdelbaky, Amr</creator><creator>Alon, Achilles</creator><creator>Shankar, Sudha S</creator><creator>Rudd, James H F</creator><creator>Fayad, Zahi A</creator><creator>Hoffmann, Udo</creator><creator>Tawakol, Ahmed</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>201612</creationdate><title>Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study</title><author>Singh, Parmanand ; Emami, Hamed ; Subramanian, Sharath ; Maurovich-Horvat, Pal ; Marincheva-Savcheva, Gergana ; Medina, Hector M ; Abdelbaky, Amr ; Alon, Achilles ; Shankar, Sudha S ; Rudd, James H F ; Fayad, Zahi A ; Hoffmann, Udo ; Tawakol, Ahmed</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p126t-94bf77c6718d1306730c6d554294b057ad91563346d6517fdc8b6bf9d8f9830a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anti-Inflammatory Agents - therapeutic use</topic><topic>Atorvastatin - therapeutic use</topic><topic>Biomarkers - blood</topic><topic>Computed Tomography Angiography</topic><topic>Coronary Angiography - methods</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - drug therapy</topic><topic>Coronary Vessels - diagnostic imaging</topic><topic>Coronary Vessels - drug effects</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18 - administration & dosage</topic><topic>Humans</topic><topic>Inflammation Mediators - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Plaque, Atherosclerotic</topic><topic>Positron Emission Tomography Computed Tomography</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Radiopharmaceuticals - administration & dosage</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>United States</topic><topic>Vascular Calcification - diagnostic imaging</topic><topic>Vascular Calcification - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Singh, Parmanand</creatorcontrib><creatorcontrib>Emami, Hamed</creatorcontrib><creatorcontrib>Subramanian, Sharath</creatorcontrib><creatorcontrib>Maurovich-Horvat, Pal</creatorcontrib><creatorcontrib>Marincheva-Savcheva, Gergana</creatorcontrib><creatorcontrib>Medina, Hector M</creatorcontrib><creatorcontrib>Abdelbaky, Amr</creatorcontrib><creatorcontrib>Alon, Achilles</creatorcontrib><creatorcontrib>Shankar, Sudha S</creatorcontrib><creatorcontrib>Rudd, James H F</creatorcontrib><creatorcontrib>Fayad, Zahi A</creatorcontrib><creatorcontrib>Hoffmann, Udo</creatorcontrib><creatorcontrib>Tawakol, Ahmed</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Circulation. Cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Singh, Parmanand</au><au>Emami, Hamed</au><au>Subramanian, Sharath</au><au>Maurovich-Horvat, Pal</au><au>Marincheva-Savcheva, Gergana</au><au>Medina, Hector M</au><au>Abdelbaky, Amr</au><au>Alon, Achilles</au><au>Shankar, Sudha S</au><au>Rudd, James H F</au><au>Fayad, Zahi A</au><au>Hoffmann, Udo</au><au>Tawakol, Ahmed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study</atitle><jtitle>Circulation. Cardiovascular imaging</jtitle><addtitle>Circ Cardiovasc Imaging</addtitle><date>2016-12</date><risdate>2016</risdate><volume>9</volume><issue>12</issue><eissn>1942-0080</eissn><abstract>Nonobstructive coronary plaques manifesting high-risk morphology (HRM) associate with an increased risk of adverse clinical cardiovascular events. We sought to test the hypothesis that statins have a greater anti-inflammatory effect within coronary plaques containing HRM.
In this prospective multicenter study, 55 subjects with or at high risk for atherosclerosis underwent
F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and after 12 weeks of treatment with atorvastatin. Coronary arterial inflammation (
F-fluorodeoxyglucose uptake, expressed as target-to-background ratio) was assessed in the left main coronary artery (LMCA). While blinded to the PET findings, contrast-enhanced computed tomographic angiography was performed to characterize the presence of HRM (defined as noncalcified or partially calcified plaques) in the LMCA. Arterial inflammation (target-to-background ratio) was higher in LMCA segments with HRM than those without HRM (mean±SEM: 1.95±0.43 versus 1.67±0.32 for LMCA with versus without HRM, respectively; P=0.04). Moreover, atorvastatin treatment for 12 weeks reduced target-to-background ratio more in LMCA segments with HRM than those without HRM (12 week-baseline Δtarget-to-background ratio [95% confidence interval]: -0.18 [-0.35 to -0.004] versus 0.09 [-0.06 to 0.26]; P=0.02). Furthermore, this relationship between coronary plaque morphology and change in LMCA inflammatory activity remained significant after adjusting for baseline low-density lipoprotein and statin dose (β=-0.27; P=0.038).
In this first study to evaluate the impact of statins on coronary inflammation, we observed that the anti-inflammatory impact of statins is substantially greater within coronary plaques that contain HRM features. These findings suggest an additional mechanism by which statins disproportionately benefit individuals with more advanced atherosclerotic disease.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00703261.</abstract><cop>United States</cop><pmid>27956407</pmid></addata></record> |
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| identifier | EISSN: 1942-0080 |
| ispartof | Circulation. Cardiovascular imaging, 2016-12, Vol.9 (12) |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Aged Anti-Inflammatory Agents - therapeutic use Atorvastatin - therapeutic use Biomarkers - blood Computed Tomography Angiography Coronary Angiography - methods Coronary Artery Disease - blood Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - drug therapy Coronary Vessels - diagnostic imaging Coronary Vessels - drug effects Double-Blind Method Female Fluorodeoxyglucose F18 - administration & dosage Humans Inflammation Mediators - blood Male Middle Aged Plaque, Atherosclerotic Positron Emission Tomography Computed Tomography Predictive Value of Tests Prospective Studies Radiopharmaceuticals - administration & dosage Risk Factors Severity of Illness Index Time Factors Treatment Outcome United States Vascular Calcification - diagnostic imaging Vascular Calcification - drug therapy |
| title | Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study |
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