Randomized evaluation of atorvastatin in patients with coronary heart disease: a serial intravascular ultrasound study.
BACKGROUND
It is unclear whether a marked reduction of low-density lipoprotein-cholesterol (LDL-C) in patients with coronary heart disease (CHD) and mild hypercholesterolemia leads to less progression of atherosclerosis.


RESULTS
Patients with CHD and hypercholesterolemia (100<LDL-C<140 mg/dl) who underwent coronary angiography (CAG) and intravascular ultrasound (IVUS) were randomly assigned to the atorvastatin (10-20 mg/day) group or ;usual care' group. After 12 months 58 patients had follow-up CAG and IVUS studies that could be evaluated. Cross-sectional areas of the vessel, lumen, and plaque were measured at 1-mm intervals, and volumetric calculations were based on Simpson's rule. After 12 months, the mean reduction of LDL-C was 34% in the atorvastatin group and 0% in the usual care group (p<0.01). The mean absolute plaque volume showed a larger increase in the usual care group than in the atorvastatin group (atorvastatin -1.4+/-11.6 mm3, usual care 7.6+/-10.3 mm3; p<0.01). Vessel volume also showed a larger increase in the usual care group than in the atorvastatin group (atorvastatin 2.2+/-10.9 mm3, usual care 10.9+/-17.7 mm3; p=0.03).


CONCLUSIONS
Atorvastatin treatment prevented the further progression of atherosclerosis by maintaining LDL-C below 100 mg/dl in patients with CHD and hypercholesterolemia (100<LDL-C<140 mg/dl).
Division of Cardiology and Vascular Regenerative Medicine, Department of Medicine, Kyoto Prefectural University School of Medicine, Japan. yamada-t@koto.kpu-m.ac.jp
Takashi
T
Yamada
Akihiro
A
Azuma
Susumu
S
Sasaki
Takahisa
T
Sawada
Hiroaki
H
Matsubara
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000209:etiology; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000627:therapeutic use*; D018084:Ultrasonography, Interventional
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin