title: Comparison of intensive and low-dose atorvastatin therapy in the reduction of carotid intimal-medial thickness in patients with coronary heart disease.
abstract: BACKGROUND
  Intensive statin therapy has been shown to improve prognosis in patients with coronary heart disease (CHD). It is unknown whether such benefit is mediated through the reduction of atherosclerotic plaque burden.
  
  
  OBJECTIVE
  To examine the efficacy of high-dose atorvastatin in the reduction of carotid intimal-medial thickness (IMT) and inflammatory markers in patients with CHD.
  
  
  METHODS
  Randomised trial.
  
  
  METHODS
  Single centre.
  
  
  METHODS
  112 patients with angiographic evidence of CHD.
  
  
  METHODS
  A high dose (80 mg daily) or low dose (10 mg daily) of atorvastatin was given for 26 weeks.
  
  
  METHODS
  Carotid IMT, C-reactive protein (CRP) and proinflammatory cytokine levels were assessed before and after therapy.
  
  
  RESULTS
  The carotid IMT was reduced significantly in the high-dose group (left: mean (SD), 1.24 (0.48) vs 1.15 (0.35) mm, p = 0.02; right: 1.12 (0.41) vs 1.01 (0.26) mm, p = 0.01), but was unchanged in the low-dose group (left: 1.25 (0.55) vs 1.20 (0.51) mm, p = NS; right: 1.18 (0.54) vs 1.15 (0.41) mm, p = NS). The CRP levels were reduced only in the high-dose group (from 3.92 (6.59) to 1.35 (1.83) mg/l, p = 0.01), but not in the low-dose group (from 2.25 (1.84) to 3.36 (6.15) mg/l, p = NS). A modest correlation was observed between the changes in carotid IMT and CRP (r = 0.21, p = 0.03).
  
  
  CONCLUSIONS
  In patients with CHD, intensive atorvastatin therapy results in regression of carotid atherosclerotic disease, which is associated with reduction in CRP levels. On the other hand, a low-dose regimen only prevents progression of the disease.
authors.affiliation: Division of Cardiology, SH Ho Cardiovascular and Stroke Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. cmyu@cuhk.edu.hk
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.forename: Linda
authors.initials: L
authors.lastname: Lam
authors.forename: Hong
authors.initials: H
authors.lastname: Lin
authors.forename: Shun-Ling
authors.initials: SL
authors.lastname: Kong
authors.forename: Wilson
authors.initials: W
authors.lastname: Chan
authors.forename: Jeffrey Wing-Hong
authors.initials: JW
authors.lastname: Fung
authors.forename: Kenny K K
authors.initials: KK
authors.lastname: Cheng
authors.forename: Iris Hiu-Shuen
authors.initials: IH
authors.lastname: Chan
authors.forename: Stephen Wai-Luen
authors.initials: SW
authors.lastname: Lee
authors.forename: John E
authors.initials: JE
authors.lastname: Sanderson
authors.forename: Christopher Wai-Kei
authors.initials: CW
authors.lastname: Lam
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000032:analysis; D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D003327:Coronary Disease / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D020382:Interleukin-18 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage* / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D020382:Interleukin-18; D015850:Interleukin-6; D016209:Interleukin-8; D008055:Lipids; D011758:Pyrroles; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000069059:Atorvastatin