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Does statin therapy affect the progression of atherosclerosis measured by a coronary calcium score?

Edward A Gill1

  • 1Harborview Medical Center, Seattle, WA 98104, USA. eagill@u.washington.edu

Current Atherosclerosis Reports
|April 29, 2010
PubMed

Insights

Coronary calcium scoring using CT scans does not show statin treatment reducing coronary artery disease progression. Recent trials indicate progression is similar to placebo, challenging prior observational data.

Area of Science:

  • Cardiovascular Imaging
  • Medical Imaging
  • Radiology

Background:

  • Coronary atherosclerosis is a major global cause of mortality.
  • CT-derived coronary calcium scoring is an evolving diagnostic tool.
  • The impact of statin therapy on coronary calcium progression was previously debated.

Purpose of the Study:

  • To evaluate the effect of statin pharmacotherapy on coronary artery disease progression as assessed by coronary calcium scoring.
  • To clarify the utility of coronary calcium scoring in monitoring medical treatment efficacy.

Main Methods:

  • Analysis of data from five recent randomized controlled trials.
  • Comparison of coronary calcium progression rates in patients receiving statin treatment versus placebo.

Main Results:

  • Five randomized controlled trials demonstrated that statin treatment does not reduce coronary calcium.
  • Progression of coronary calcium in patients on statin therapy was indistinguishable from placebo.
  • This finding contradicts earlier retrospective and observational data.

Conclusions:

  • Coronary calcium scoring does not support the notion that statin therapy reduces coronary artery disease progression.
  • The efficacy of statin pharmacotherapy in altering coronary calcium burden requires re-evaluation.
  • Current evidence suggests coronary calcium progression is not a reliable marker for statin treatment effects.

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