Effects of lipid-lowering by simvastatin on human atherosclerotic lesions: a longitudinal study by high-resolution, noninvasive magnetic resonance imaging.
BACKGROUND
This study was designed to investigate the effects of lipid-lowering by simvastatin on human atherosclerotic lesions.


RESULTS
Eighteen asymptomatic hypercholesterolemic patients with documented aortic and/or carotid atherosclerotic plaques were selected for the study. A total of 35 aortic and 25 carotid artery plaques were detected. Serial black-blood MRI of the aorta and carotid artery of the patients was performed at baseline and 6 and 12 months after lipid-lowering therapy with simvastatin. The effects of the treatment on atherosclerotic lesions were measured as changes in lumen area, vessel wall thickness, and vessel wall area, a surrogate of atherosclerotic burden. Simvastatin induced a significant (P<0.01) reduction in total and LDL cholesterol levels at 6 weeks that was maintained thereafter. At 6 months, no changes in lumen area, vessel wall thickness, or vessel wall area were observed. However, at 12 months, significant reductions in vessel wall thickness and vessel wall area, without changes in lumen area, were observed in both aortic and carotid arteries (P<0.001).


CONCLUSIONS
This in vivo human study demonstrates that effective and maintained lipid-lowering therapy by simvastatin is associated with a significant regression of atherosclerotic lesions. Our observation suggests that statins induce vascular remodeling, as manifested by reduced atherosclerotic burden without changes in the lumen.
Corti
R
R
Cardiovascular Biology Research Laboratory, the Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY, USA.
Fayad
Z A
ZA
Fuster
V
V
Worthley
S G
SG
Helft
G
G
Chesebro
J
J
Mercuri
M
M
Badimon
J J
JJ
D001011:Aorta / Q000187:drug effects / Q000473:pathology; D001018:Aortic Diseases / Q000175:diagnosis / Q000188:drug therapy; D001161:Arteriosclerosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D002339:Carotid Arteries / Q000187:drug effects / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000188:drug therapy; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D012074:Remission Induction; D019821:Simvastatin / Q000627:therapeutic use*; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects
D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D002784:Cholesterol; D019821:Simvastatin