Rationale and Design of the Carotid Plaque in Human for All Evaluations With Aggressive Rosuvastatin Therapy (CHALLENGER Trial) Evaluation by Magnetic Resonance Imaging

Abstract

Background Intensive lipid-lowering therapy with statins reduces levels of low-density lipoprotein (LDL)-cholesterol (C) and improves plaque volume and composition in patients with cardiovascular disease. Furthermore, rosuvastatin ameliorated carotid stenosis in the ASTEROID study, and altered the composition of plaques in a predominantly Caucasian study population in the ORION study. However, it is not known whether statin therapy achieves similar quantitative improvement in carotid artery plaque in other ethnic groups. Methods and ResultsFifty patients with hypercholesterolemia (LDL-C ≥120 mg/dl) and a maximum carotid intima-media thickness ≥1.8 mm will be enrolled and treated with rosuvastatin at a dose of 5 mg/day for 96 weeks. The primary endpoints will be the percent change of carotid plaque volume and the change in plaque composition after 96 weeks of treatment, as evaluated by magnetic resonance imaging. Conclusions The CHALLENGER study will provide a noninvasive assessment of the changes in carotid plaque volume and composition achieved by reduction of LDL levels in Japanese patients with carotid stenosis on long-term rosuvastatin therapy. (Circ J 2009; 73: 111 -115)

Association Between Green Tea Intake and Coronary Artery Disease in a Chinese Population

“…7,8 Lipid-lowering therapy could induce significant coronary plaque regression and the percentage of change in the plaque volume showed a positive correlation with the percentage of change in the low-density lipoprotein (LDL)-C level. 24 Underlying mechanisms for the lipid-lowering effects of catechins include reduction of cholesterol absorption, 8 inhibition of cholesterol synthesis 25 and upregulation of the hepatic LDL receptor. 25 The strong antioxidant activity of green tea may be another explanation of its preventive effect on coronary atherosclerosis.…”

Metabolic Syndrome and Carotid Artery Parameter in Koreans Aged 50 Years and Older

“…[41][42][43] Plaque is formed by inflammation, oxidation, and endothelial dysfunction as a late response compared with thickening of the intimamedia. [44][45][46][47][48] When the entire study population (4,088), including subjects with hypertension, diabetes, and dyslipidemia, were included in the analysis, the relationship between MetS and carotid plaques was significant in both men (OR 1.45, 95%CI 1.16-1.81) and women (OR 1.65, 95%CI 1.36-1.99). Additional prospective investigations are needed to further examine the sex differences in the relationship between MetS and subclinical atherosclerosis.…”

Carotid Magnetic Resonance Imaging

“…77 Future studies are warranted to evaluate plaque progression/regression after treatment intervention in not only Western populations but other populations as well. [55][56][57][58]78 Summary and Future Directions MRI of carotid atherosclerosis is a unique method of characterizing plaque morphology and tissue composition and, to a certain extent, plaque inflammation. Because of its noninvasiveness, it has many current and potential applications; the fact that it is the only technique that can examine the fibrous cap status in vivo makes it a powerful tool for identifying high-risk plaques.…”