Aortic plaque regression as determined by magnetic resonance imaging with high-dose and low-dose statin therapy.
OBJECTIVE
We sought to compare the effects of high-dose with low-dose simvastatin therapy on aortic plaque morphology using transoesophageal magnetic resonance imaging (TEMRI).


METHODS
Thirty-one patients with established moderate-to-severe atherosclerosis were recruited and randomized to 80 versus 20 mg/day simvastatin therapy. Aortic vessel wall and lumen volumes and areas were measured by TEMRI at baseline and 12 months.


RESULTS
Significant differences were observed between the low-dose and high-dose statin therapy in reduction of low-density lipoprotein cholesterol (LDL-c) (10 mg/dl, P = 0.001), total cholesterol (16.2 mg/dl, P < 0.001), vessel wall area (19.0 mm2, P < 0.001) and volume (343.4 mm3, P < 0.001), as well as increase in lumen area (54.4 mm2, P < 0.001) and volume (1038 mm3, P < 0.001). LDL-c lowering was significantly associated with aortic wall area and volume reduction in both groups.


CONCLUSIONS
High-dose statin leads to greater LDL-c reduction, aortic vessel wall reduction and lumen increase than low-dose statin therapy in patients with at least moderate-documented atherosclerosis.
Johns Hopkins School of Medicine, Baltimore, Maryland, USA. igottli1@jhmi.edu
Ilan
I
Gottlieb
Sachin
S
Agarwal
Sandeep
S
Gautam
Milind
M
Desai
Henning
H
Steen
William P
WP
Warren
Sérgio Salles
SS
Xavier
João A C
JA
Lima
D000368:Aged; D001018:Aortic Diseases / Q000188:drug therapy* / Q000473:pathology*; D001161:Arteriosclerosis / Q000188:drug therapy* / Q000473:pathology*; D002784:Cholesterol / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007091:Image Processing, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D019821:Simvastatin / Q000008:administration & dosage*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol; D019821:Simvastatin