Intensive Statin Therapy Reduces Coronary Plaque

A new study shows that very intensive cholesterol lowering with a statin drug can partially reverse the buildup of plaque in the coronary arteries.

The study was conducted at 53 community and tertiary care centers in the United States, Canada, Europe, and Australia. A total of 507 patients had baseline intravascular ultrasound (IVUS) examination, a technique in which a tiny ultrasound probe is inserted into the coronary arteries to measure plaque. Atherosclerosis progression was assessed at baseline and at 24 months of treatment. All patients received 40 mg daily of rosuvastatin, a statin marketed under the brand name Crestor.

Results showed that regression occurred for all three pre-specified IVUS measures of disease burden. The mean baseline low density lipoprotein (LDL) cholesterol dropped by 53.2%, and mean high density lipoprotein (HDL) cholesterol increased by 14.7%. Arterial plaque overall was reduced by 6.8-9.1% for the various measures of disease burden. This is the largest reduction in cholesterol ever observed in a major statin outcome trial. The results were presented at the American College of Cardiology's annual scientific session, held during March 2006 in Atlanta (GA, USA).

"Previous similar studies with statins have shown slowing of coronary disease, but not regression. This regimen significantly lowered bad cholesterol, and surprisingly, markedly increased good cholesterol levels,” said Steven Nissen, M.D., of the Cleveland Clinic (OH, USA), president-elect of the American college of cardiology and lead author of the study. "We conclude that very low LDL levels [below current guidelines], when accompanied by raised HDL, can regress, or partially reverse, the plaque buildup in the coronary arteries.”

Rosuvastatin blocks the production of cholesterol in the liver, and is used to treat patients with high cholesterol after diet and exercise have not been able to lower cholesterol sufficiently.



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