Atherosclerotic disease regression with statins: studies using vascular markers.
Vascular imaging techniques enable identification of atherosclerosis in the sub-clinical phase and allow assessment of interventions to modify disease progression. Angiography has limited utility for tracking the progression of atherosclerosis because of its invasive nature, limited sensitivity for detecting early lesions and relatively low interscan reproducibility. Intravascular ultrasound (IVUS)an electron beam computed tomography (EBCT) are more sensitive and reproducible; however, available data on their ability for tracking disease progression are few. Measurement of carotid intima media thickness (CIMT) by B-mode ultrasound is a well-validated procedure for this application. In comparison with angiography, CIMT demonstrates greater sensitivity for detecting early atherosclerosis and lipid-rich plaques that are vulnerable to rupture. Continued validation and development of imaging techniques, such as magnetic resonance imaging (MRI), will facilitate the assessment of atherosclerosis progression in intervention studies. Stains are effective low-density lipoprotein cholesterol (LDL-C) lowering agents, and imaging studies have demonstrated their ability to slow progression and promote regression of atherosclerosis. The benefits of therapy on atherosclerosis regression appear to extend to soft atherosclerotic plaques that are still developing and treatment effects are independent of baseline LDL-C level. Hence, imaging studies support early intervention with statins in coronary heart disease patients, irrespective of lipid level.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, HP D01.335, P.O. Box 85500, Utrecht 3508 GA, The Netherlands. d.e.grobbee@jc.azu.nl
Diederick E
DE
Grobbee
Michiel L
ML
Bots
D002986:Clinical Trials as Topic; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D004452:Echocardiography; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008279:Magnetic Resonance Imaging; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids