Effects of Aggressive Versus Conventional Lipid-Lowering Therapy by Simvastatin on Human Atherosclerotic Lesions

Abstract

Effective and protracted lipid-lowering therapy with simvastatin is associated with a significant regression of atherosclerotic lesions. No difference in vessel wall changes was seen between high and conventional doses of simvastatin. Changes in vessel wall parameters are more related to LDL-C reduction rather than to the dose of statin.

Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment

“…Our results are in line with prior reports of study participants with extensive carotid disease, showing that regression of carotid wall measurements during lipid‐lowering therapy can occur 12, 13. Table 3 provides an overview of prior studies 15, 29, 30.…”

“…Coronary artery calcium (CAC) score has been intensively studied in this regard, but multiple studies have shown either progression of CAC or lack of regression during treatment 9, 10. In contrast, longitudinal measurements of atherosclerotic plaque using intravascular ultrasound (IVUS)11 and carotid artery magnetic resonance imaging (MRI)12, 13, 14 have shown that these technologies can be used to assess change in atheroma during statin therapy.…”

Métodos por imagem da aterosclerose em estudos de progressão/regressão: marcador substituto ou janela direta para o processo patológico da aterosclerose?

“…Studies with carotid MRI demonstrated an interstudy reproducibility of 4.4% 85 . A number of serial studies in humans have assessed CMR in the longitudinal measurement of aortic and carotid atheroma [86][87][88][89][90] .…”

“…In a double-blind study, newly diagnosed hypercholesterolemic patients (n = 51) with asymptomatic aortic and/or carotid atherosclerotic plaques were randomized to 20 mg/day (n = 29) or 80 mg/day (n = 22) simvastatin 88 . Mean follow-up was 18.1 months.…”

Reproducibility and Reliability of Atherosclerotic Plaque Volume Measurements in Peripheral Arterial Disease with Cardiovascular Magnetic Resonance

“…While CMR has been employed for measuring and characterizing plaque in the coronary (13,14), carotid (15,16), and aortic circulations (15)(16)(17), few studies have rigorously investigated its role in PAD (12,18). The goal of this study was to develop and refine a practical technique for quantifying plaque in the superficial femoral artery (SFA) of patients with mild to moderate PAD that would allow for determination of plaque burden and noninvasive, serial monitoring of plaque progression in patients treated with both established and novel therapies.…”