Randomized evaluation of atorvastatin in patients with coronary heart disease: a serial intravascular ultrasound...

Area of Science:

• Cardiology
• Vascular Biology
• Pharmacology

Background:

• The impact of significant low-density lipoprotein-cholesterol (LDL-C) reduction on atherosclerosis progression in patients with coronary heart disease (CHD) and mild hypercholesterolemia remains unclear.
• Mild hypercholesterolemia is defined as LDL-C levels between 100 and 140 mg/dl.

Purpose of the Study:

• To investigate the effect of atorvastatin on atherosclerosis progression in patients with CHD and mild hypercholesterolemia.
• To determine if maintaining LDL-C below 100 mg/dl with atorvastatin prevents atheroma progression.

Main Methods:

• A randomized controlled trial involving 58 patients with CHD and mild hypercholesterolemia (LDL-C 100-140 mg/dl).
• Patients were assigned to either atorvastatin (10-20 mg/day) or usual care.
• Coronary angiography (CAG) and intravascular ultrasound (IVUS) were performed at baseline and after 12 months to assess plaque and vessel volumes.

Main Results:

• Atorvastatin treatment resulted in a 34% mean reduction in LDL-C compared to no change in the usual care group (p<0.01).
• The atorvastatin group showed a significant decrease in absolute plaque volume (-1.4 mm3) versus an increase in the usual care group (7.6 mm3; p<0.01).
• Vessel volume increased less in the atorvastatin group (2.2 mm3) than in the usual care group (10.9 mm3; p=0.03).

Conclusions:

• Atorvastatin therapy effectively prevents further atherosclerosis progression in patients with CHD and mild hypercholesterolemia.
• Maintaining LDL-C levels below 100 mg/dl through atorvastatin treatment is crucial for inhibiting atheroma development in this patient cohort.