The role of statins in reversing atherosclerosis: what the latest regression studies show

Recent clinical trials confirm that aggressive lipid-lowering therapy with statins decreases low density lipoprotein (LDL) cholesterol to well below 100 mg/dL in high risk patients, and prevents cardiovascular events. Similarly, aggressive lipid lowering is being explored as a possible means of promoting regression of atherosclerosis and of affording greater protection from atherosclerotic events. A growing body of evidence indicates that intensive statin therapy, particularly in high risk patients, slows the rate of progression of atherosclerosis compared with moderate therapy, and that reductions of > or =40% in LDL cholesterol are necessary to achieve atherosclerosis regression. Questions remain regarding the extent of regression achieved with statin therapy and whether to dose statins to achieve a specific LDL-cholesterol level or a certain percent reduction; however, ongoing clinical trials may provide insight and guidance.