Can intensive statin therapy halt the progression of atherosclerosis? Recent evidence and potential implications for patient management.
A number of studies using various imaging techniques have demonstrated that intensive lipid lowering with statins can halt or delay the progression of atherosclerosis and even, in some cases, lead to plaque regression. Improvements in atheroma burden with intensive statin therapy appear to be related not just to decreasing low-density lipoprotein cholesterol but also to anti-inflammatory and antiproliferative effects. Clinical trial results also suggest that achieving low-density lipoprotein cholesterol levels even lower than those currently recommended can produce improved clinical outcomes across a range of patient types. Given this body of evidence, it appears appropriate to use intensive statin therapy to treat dyslipidemic patients at high risk for coronary heart disease.
From the Department of Family Medicine, University of California at Irvine, Irvine, CA, USA. pamkushner@hotmail.com
Pamela R
PR
Kushner
D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006328:Cardiac Catheterization; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D002986:Clinical Trials as Topic; D017023:Coronary Angiography; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control; D018450:Disease Progression; D016903:Drug Monitoring / Q000379:methods; D004452:Echocardiography; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000276:immunology / Q000494:pharmacology / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors