Intensive-Dose Atorvastatin Regimen Halts Progression of Atherosclerotic Plaques in New-onset Unstable Angina With Borderline Vulnerable Plaque Lesions

Abstract

To compare the therapeutic effects of intensive versus moderate dosage of atorvastatin regimens in new-onset unstable angina with borderline lesions, 100 patients were randomized to receive either 80 mg/d or 20 mg/d atorvastatin for 9 months. Clinical symptoms, lipid profiles, and coronary stenosis (evaluated by coronary angiography and intravascular ultrasound) were compared to their corresponding baselines within each group and between the 2 groups after 9 months of treatment. The results showed that (1) when compared to their corresponding baselines, both groups exhibited improvement in clinical symptoms, a significant decrease in total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), and high-sensitivity C-reactive protein (hs-CRP; P < .01) and a significant increase in high-density lipoprotein cholesterol (HDL-C); (2) the improvement in clinical symptoms and the decrease in LDL-C and hs-CRP were significantly greater (P < .01) in the intensive-dose group than in the moderate-dose group; (3) the mean plaque volume did not progress in the intensive-dose group but increased significantly (P < .05) in the moderate-dose group. We conclude that compared to the moderate dose, the intensive-dose regimen significantly improves clinical symptoms, lowers LDL-C and hs-CRP, and halts the progression of borderline atherosclerotic plaques in patients with new-onset unstable angina.

Use of Atorvastatin in Lipid Disorders and Cardiovascular Disease in Chinese Patients

“…Thirteen RCTs with 4,145 patients were finally included [ Table 2 ]. [ 27 33 41 42 43 48 49 50 51 52 53 54 55 ] The incidence of hepatic and musculoskeletal toxicity and the adherence of medication were pooled using the Mantel-Haenszel Method with random effect model (STATA 11.0; STATA Corp., TX, USA). No case of rhabdomyolysis or CK > 10 ULN was reported.…”

Effects of statin therapy on coronary plaque volume by decreasing CRP/hsCRP levels: A meta-regression of randomized controlled trials

“…One was excluded due to a discrepancy between the number of participants receiving statins and the number of people participating in IVUS measurements, and two were excluded because of data quality. Overall, this analysis included 12 trials [16][17][18][19][20][21][22][23][24][25][26][27]. Fig.…”

“…Articles reported mean values and standard deviation (SD) of change of TAV/PV/PAV, the original number was entered. Some studies [10][11][12][13] did not report SD values, which were filled by using the SD of the baseline data of control group. 1 study [14] provided SE rather than SD, and then SD value was calculated based on SE value.…”

The difference between Asian and Western in the effect of LDL-C lowering therapy on coronary atherosclerotic plaque: a meta-analysis report

“…Briefly, of the initial 673 articles, one hundred and twenty-two of abstracts were reviewed, resulting in exclusion of 102 articles, and 20 articles were reviewed in full text, resulting in exclusion of 10 trials and inclusion of 18 additional trials cited in the 20 articles. Twenty two RCTs [ 4 – 25 ] and six blinded end-points trial [ 26 – 31 ] were carefully evaluated, and eight trials [ 4 , 8 , 9 , 18 , 19 , 21 , 27 , 31 ] were excluded because of specific the index of plaque or lack of some data. Sixteen RCT (ESTABLISH [ 11 ], REVERSAL [ 10 ], A-PLUS [ 5 ], ACTIVATE [ 6 ], ILLUSTRATE [ 7 ], JAPAN-ACS [ 20 ], REACH [ 14 ], SATURN [ 16 ], ARTMAP [ 17 ], ERASE [ 23 ], STRADIVARIUS [ 24 ], PERISCOPE [ 25 ], and trials by Yokoyama M [ 12 ], by Kawasaki M [ 13 ], by Hong MK [ 15 ], and Tani S [ 22 ]) and four blinded end-points trial (ASTEROID [ 26 ], COSMOS [ 29 ], trial by Jensen LO [ 28 ] and trial by Nasu K [ 30 ]) were finally analyzed.…”