Effect of atorvastatin (80 mg/day) versus pravastatin (40 mg/day) on arterial remodeling at coronary branch points (from the REVERSAL study).
The effect of moderate and intensive lipid lowering on plaque progression and arterial remodeling at coronary branch points was investigated. Intensive (+1 +/- 19.6%), but not moderate (+4.1 +/- 15.1%), lipid lowering prevented an increase in the percent [corrected] plaque area at the branch points. The 2 strategies were associated with increased areas of the lumen (+7.6% to 9.4%) and external elastic membrane (+9.6% to 10.8%). In contrast, there was no significant change in plaque, lumen, and/or external elastic membrane areas at the nonbranch point site. These results suggest that intensive lipid lowering can have a dramatic effect on atheroma-prone regions and that remodeling in response to changes in plaque is a heterogenous process.
Nicholls
Stephen J
SJ
Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Tuzcu
E Murat
EM
Schoenhagen
Paul
P
Sipahi
Ilke
I
Crowe
Tim
T
Kapadia
Samir
S
Nissen
Steven E
SE
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000008:administration & dosage / Q000627:therapeutic use*; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin; D017035:Pravastatin