title: Effect of lipid-lowering therapy with atorvastatin on atherosclerotic aortic plaques detected by noninvasive magnetic resonance imaging.
abstract: OBJECTIVE
  We sought to elucidate the effects of 20-mg versus 5-mg atorvastatin on thoracic and abdominal aortic plaques.
  
  
  BACKGROUND
  Regression of thoracic aortic plaques by simvastatin was demonstrated using magnetic resonance imaging (MRI). However, the effects of different doses of statin have not been assessed.
  
  
  METHODS
  Using MRI, we investigated the effects of 20-mg versus 5-mg atorvastatin on thoracic and abdominal aortic plaques in 40 hypercholesterolemic patients who were randomized to receive either dose. Treatment effects were evaluated as changes in vessel wall thickness (VWT) and vessel wall area (VWA) of atherosclerotic lesions from baseline to 12 months of treatment.
  
  
  RESULTS
  The 20-mg dose induced a greater low-density lipoprotein (LDL) cholesterol reduction than did the 5-mg dose (-47% vs. -34%, p < 0.001). Although 20 mg and 5 mg reduced C-reactive protein (CRP) levels (-47% and -28%), the degree of CRP reduction did not differ between the two doses. The 20-mg dose reduced VWT and VWA of thoracic aortic plaques (-12% and -18%, p < 0.001), whereas 5 mg did not (+1% and +4%). Regarding abdominal aortic plaques, even 20 mg could not reduce VWT or VWA (-1% and +3%), but instead progression was observed with 5-mg treatment (+5% and +12%, p < 0.01). Notably, the degree of plaque regression in thoracic aorta correlated with LDL cholesterol (r = 0.64) and CRP (r = 0.49) reductions. Although changes in abdominal aortic plaques only weakly correlated with LDL cholesterol reduction (r = 0.34), they correlated with age (r = 0.41).
  
  
  CONCLUSIONS
  One-year 20-mg atorvastatin treatment induced regression of thoracic aortic plaques with marked LDL cholesterol reduction, whereas it resulted in only retardation of plaque progression in abdominal aorta. Thoracic and abdominal aortic plaques may have different susceptibilities to lipid lowering.
authors.affiliation: National Defense Medical College, Saitama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yonemura
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Momiyama
authors.forename: Zahi A
authors.initials: ZA
authors.lastname: Fayad
authors.forename: Makoto
authors.initials: M
authors.lastname: Ayaori
authors.forename: Reiko
authors.initials: R
authors.lastname: Ohmori
authors.forename: Kenji
authors.initials: K
authors.lastname: Higashi
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Kihara
authors.forename: Shojiro
authors.initials: S
authors.lastname: Sawada
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Iwamoto
authors.forename: Masatsune
authors.initials: M
authors.lastname: Ogura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kusuhara
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nagata
authors.forename: Haruo
authors.initials: H
authors.lastname: Nakamura
authors.forename: Seiichi
authors.initials: S
authors.lastname: Tamai
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Ohsuzu
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001012:Aorta, Abdominal / Q000473:pathology; D001013:Aorta, Thoracic / Q000473:pathology; D001018:Aortic Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D001161:Arteriosclerosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin