[Regression of a coronary atheroma. Proof and doubts]

The regression of coronary atheroma appears to have been convincingly demonstrated by epidemiology or experimental models. Studies involving prevention based upon influencing the lipid factor have clearly shown a decrease in coronary events when drugs cause a lowering of blood lipids. Atheromatous lesions induced in the animal regress if exposure to the factors which have favourised these lesions is eliminated. Studies in man have confirmed the regression of atherosclerotic lesions in several vascular areas. Atheromatous coronary stenoses appear to regress or stabilise, essentially under the influence of hypolipidemic agents but also that of calcium inhibitors, platelet anti-agregants and, probably, anti-oxidising drugs. The clinical value of these therapeutic actions remains to be evaluated and the fate of fibrous lesions is not known. In contrast, relatively early lesions may already derive benefit from this new concept. Methods for assessment of regression in man nevertheless remain imperfect and require a very strict study protocol and methodology.