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Published on: September 27, 2024
Rosuvastatin Slows Progression of Carotid Intima-Media Thickness: The METEOR-China Randomized Controlled Study
Huaguang Zheng1,2, Hongwei Li3, Yilong Wang1,2
1Beijing Tiantan Hospital, Capital Medical University, China (H.Z., Yilong Wang, Yongjun Wang).
Insights
Rosuvastatin significantly slowed carotid intima-media thickness progression in Chinese adults with subclinical atherosclerosis over two years. This lipid-lowering therapy was well-tolerated and demonstrated a favorable safety profile.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Atherosclerosis is a primary driver of cardiovascular disease globally, particularly in China.
- Lipid-lowering interventions offer a key strategy for primary prevention of atherosclerosis.
- Carotid intima-media thickness (CIMT) is a validated biomarker for atherosclerosis progression and cardiovascular risk.
Purpose of the Study:
- To evaluate the efficacy of rosuvastatin in slowing CIMT progression in Chinese individuals with subclinical atherosclerosis.
- To assess the safety and tolerability of rosuvastatin in this population over a 2-year period.
Main Methods:
- A randomized, double-blind, placebo-controlled, multicenter study involving Chinese adults with subclinical atherosclerosis.
- Participants received either rosuvastatin 20 mg/d or a placebo for 104 weeks.
- The primary endpoint was the annualized rate of change in mean maximum CIMT across 12 carotid artery sites.
Main Results:
- Rosuvastatin treatment resulted in a significantly lower annualized rate of CIMT progression compared to placebo (difference of -0.0103 mm/y, P=0.020).
- Secondary CIMT endpoints and lipid parameter improvements were consistent with the primary findings.
- The safety profile of rosuvastatin was consistent with established data and well-tolerated.
Conclusions:
- Rosuvastatin 20 mg/d effectively reduces the progression of carotid intima-media thickness in Chinese adults with subclinical atherosclerosis over two years.
- The drug was well-tolerated, indicating its potential as a therapeutic option for primary prevention in this demographic.
Background:
Atherosclerosis is the leading cause of cardiovascular disease worldwide, including in China. Primary prevention, through lipid-lowering, could avert development of atherosclerosis. Carotid intima-media thickness (CIMT) is a well-validated measure of atherosclerosis used in intervention studies as the primary outcome and alternative end point for cardiovascular disease events.
Methods:
This randomized, double-blind, placebo-controlled, multicenter, parallel-group study assessed the effects of rosuvastatin 20 mg/d compared with placebo on progression of CIMT over 104 weeks in Chinese people with subclinical atherosclerosis. The primary end point was the annualized rate of change in mean of the maximum CIMT measurements taken 7× over the study period from each of 12 carotid artery sites (near and far walls of the right and left common carotid artery, carotid bulb, and internal carotid artery). Secondary end points included CIMT changes at different artery sites and lipid-parameter changes. Safety was also assessed.
Results:
Participants were randomized (1:1) to receive rosuvastatin (n=272) or placebo (n=271). Baseline characteristics were well balanced between groups. The change in mean of the maximum CIMT of the 12 carotid sites was 0.0038 mm/y (95% CI, -0.0023-0.0100) for the rosuvastatin group versus 0.0142 mm/y (95% CI, 0.0080-0.0204) for the placebo group, with a difference of -0.0103 mm/y (95% CI, -0.0191 to -0.0016; P=0.020). For the CIMT secondary end points, the results were generally consistent with the primary end point. There were clinically relevant improvements in lipid parameters with rosuvastatin. We observed an adverse-event profile consistent with the known safety profile of rosuvastatin.
Conclusions:
Rosuvastatin 20 mg/d significantly reduced the progression of CIMT over 2 years in Chinese adults with subclinical atherosclerosis and was well tolerated.
Registration:
URL: https://www.
Clinicaltrials:
gov; Unique identifier: NCT02546323.
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