The possible modulatory impact of high-dose statin therapy on carotid intima-media thickness: a preliminary study

Morbidity related to cardiovascular disease (CVD) is a leading epidemiological problem. Carotid intima-media thickness (CIMT) can be regarded as a surrogate marker for cardiovascular disease. Lipid-lowering agents such as statins have proven to reduce future risk and promote regression of atherosclerotic plaques.

To relate long-term high-dose statin therapy to CIMT in a retrospective analysis of patients presenting with preserved ejection fraction heart failure (HFpEF).

There were 77 (47 female and 30 male) consecutive patients with a median age of 69 (62-75) years admitted to the Hypertension and Internal Medicine Department presenting with preserved ejection fraction heart failure symptoms in NYHA class 2.0 (0.5) for clinical evaluation in 2024. Laboratory tests, echocardiography, carotid ultrasound, and cine angiography were performed. The possible relation between CIMT and patients' characteristics was evaluated.

The multivariable model indicated possible relations between CIMT above 0.8 mm and obesity (BMI > 30 kg/m²) (OR = 11.86, 95% CI: 2.5-54.02, p = 0.001), and high-statin therapy (OR = 0.18, 95% CI: 0.04-0.08, p = 0.024). The receiver operator curve (ROC) was characterized by an area under the curve (AUC) of 0.794 with an F-measure of 0.417, yielding a sensitivity of 35.7% and specificity of 91.8%.

The results from the retrospective single-measurement analysis on long-term statin therapy may indicate the relation between CIMT and rosuvastatin (at least 20 mg/day) or atorvastatin (at least 40 mg/day) administration. Long-term statin therapy is associated with a reduced likelihood of having CIMT above 0.8 mm, although the presented results are statin-type and dosage-dependent.