Effect of Very High-Intensity Statin Therapy on Regression of Coronary Atherosclerosis

Despite the higher standard of evidence required, the current study demonstrated regression for all 3 prespecified intravascular ultrasound end points with a high level of statistical significance

Steven E. Nissen; Stephen J. Nicholls; Ilke Sipahi; Peter Libby; Joel S. Raichlen; Christie M. Ballantyne; Jean Davignon; Raimund Erbel; Jean Charles Fruchart; Jean-Claude Tardif; Paul Schoenhagen; Tim Crowe; Valerie Cain; Kathy Wolski; Marlene Goormastic; E. Murat Tuzcu; for the ASTEROID Investigators


Scholarcy highlights

  • The mean change in percent atheroma volume for the entire vessel was −0.98%, with a median of −0.79%
  • The mean change in atheroma volume in the most diseased 10-mm subsegment was −6.1 mm, with a median of −5.6 mm
  • Very high-intensity statin therapy using rosuvastatin 40 mg/d achieved an average low-density lipoprotein cholesterol of 60.8 mg/dL and increased high-density lipoprotein cholesterol by 14.7%, resulting in significant regression of atherosclerosis for all 3 prespecified intravascular ultrasound measures of disease burden
  • Of the 158 patients who were not included in the IVUS analysis, 14 were lost to follow-up, 2 were withdrawn per investigator discretion, 3 were withdrawn for protocol violations, 32 patients withdrew consent, 63 were withdrawn for an adverse event, and 11 withdrew for other reasons
  • The observed increases in high-density lipoprotein-C in the current study suggest that therapies designed to simultaneously lower LDL-C while raising HDL-C have the potential to substantially reduce lesion burden in patients with established disease
  • Further studies are needed to determine the effect of the observed changes on clinical outcome

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