Related Experiment Video

Updated: Jul 19, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Coronary atherosclerosis can regress with very intensive statin therapy

Ilke Sipahi1, Stephen J Nicholls, E Murat Tuzcu

  • 1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH 44195, USA. sipahii@ccf.org

Cleveland Clinic Journal of Medicine
|October 19, 2006
PubMed

Insights

Very intensive statin therapy significantly regressed coronary atherosclerosis. The ASTEROID trial demonstrated that achieving low low-density lipoprotein cholesterol (LDL-C) levels with rosuvastatin is key for managing coronary artery disease.

Area of Science:

  • Cardiology
  • Pharmacology
  • Medical Imaging

Background:

  • Coronary artery disease (CAD) management often involves lipid-lowering therapies.
  • The role of intensive statin therapy in achieving significant plaque regression is an area of ongoing research.

Purpose of the Study:

  • To evaluate the effect of intensive rosuvastatin therapy on coronary atherosclerosis regression.
  • To assess the impact of high-dose rosuvastatin on lipid profiles, including low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C).

Main Methods:

  • The ASTEROID trial utilized serial intravascular ultrasonography (IVUS) to assess changes in coronary plaque volume.
  • Participants received rosuvastatin 40 mg once daily, a very intensive statin regimen.
  • Lipid levels, including LDL-C and HDL-C, were monitored throughout the study.

Main Results:

  • Very intensive statin therapy with rosuvastatin 40 mg led to highly significant regression of coronary atherosclerosis.
  • The mean LDL-C level achieved was 61 mg/dL.
  • A mean increase of 15% in HDL-C levels was observed.

Conclusions:

  • Intensive lipid-lowering therapy, specifically with high-dose rosuvastatin, can induce significant regression of coronary atherosclerosis.
  • The findings suggest that aiming for the lowest attainable LDL-C levels, without adverse effects, may be an optimal strategy in CAD patients.
  • Further research is needed to determine the benefits of combined LDL-C lowering and HDL-C raising therapies.

Related Concept Videos

Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Lipid-Lowering Drugs: Statins and Miscellaneous Agents01:20

Lipid-Lowering Drugs: Statins and Miscellaneous Agents

Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...