Change in Carotid Intima-Media Thickness in a High-Risk Group of Patients by Intensive Lipid-Lowering Therapy With Rosuvastatin

Abstract

SummaryCarotid intima-media thickness (IMT), a measure of atherosclerosis, is modulated by multiple risk factors. Accordingly, comprehensive control of risk factors is indispensable for management of atherosclerosis. In this study, as a posthoc analysis of the JART Study we planned two analyses. In the main analysis, we evaluated the effect of intensive lipidlowering therapy with rosuvastatin on carotid IMT in high-risk patients. We also evaluated effi cacy in the presence or absence of each risk factor using the full analysis population in the JART Study. Patients with low-density lipoprotein cholesterol (LDL-C) ≥ 140 mg/dL and max-IMT ≥ 1.1 mm were randomized to rosuvastatin or pravastatin therapy for 12 months. Dosages were allowed to increase to 10 mg/day and 20 mg/day to achieve LDL-goals (aggressive goals for rosuvastatin group and guideline goals for pravastatin group). For the main analysis, we assessed 200 high-risk patients (105 in the rosuvastatin group), as category III or secondary prevention according to the Japan Atherosclerosis Society guideline 2007, whereas we assessed 289 patients in the other analysis. Rosuvastatin signifi cantly slowed the percentage change in mean-IMT at 12 months compared with pravastatin (1.40 ± 10.03% versus 6.43 ± 13.77%, P = 0.005). LDL-C was reduced by 48.1% in the rosuvastatin group and 27.9% in the pravastatin group. The rate of achieving the LDL-C goal was signifi cantly greater in the rosuvastatin group compared with the pravastatin group (P < 0.001). Rosuvastatin slowed the change in mean-IMT in the presence of every risk factor. Thus, intensive lipid-lowering therapy reduced progression of carotid IMT in high-risk patients. (Int Heart J 2014; 55: 146-152)

Osteoprotegerin is Associated With Endothelial Function and Predicts Early Carotid Atherosclerosis in Patients With Coronary Artery Disease

“…40) In addition, statins slower the progression of CIMT. 41,42) Shimizu, et al 43) reported that ARB completely prevented calcification. These data suggest that statins and ARBs, and possibly ACEIs, or any combinations thereof, may reduce the serum levels of OPG and thus modulate the progression of CIMT.…”

Effect of Combination Therapy of Ezetimibe and Rosuvastatin on Regression of Coronary Atherosclerosis in Patients With Coronary Artery Disease

“…2,3) Statins have also been shown to slow the progression or even promote the regression of coronary atherosclerosis. [4][5][6][7][8][9][10][11] Despite the established efficacy of statins, however, the attainment of low-density-lipoprotein cholesterol (LDL-C) levels recommended by the guidelines is often suboptimal. 12) Ezetimibe is a novel cholesterol absorption inhibitor that prevents the absorption of dietary and biliary cholesterol from the small intestine.…”

Change of carotid intima‐media thickness is associated with age in elderly Japanese patients without a history of cardiovascular disease

“…Also, the present participants received various drugs for the treatment of diabetes, hypertension and dyslipidemia during the study period. Head‐to‐head clinical trials have shown that drugs differ in their effects on the progression of CIMT . Furthermore, the contributions of cardiovascular risk factors to the progression of atherosclerosis might differ among study participants.…”