title: Effect of lipid-lowering therapy with atorvastatin on atherosclerotic aortic plaques: a 2-year follow-up by noninvasive MRI.
abstract: BACKGROUND
  Using MRI, we reported plaque regression in thoracic aorta and retardation of plaque progression in abdominal aorta by 1-year atorvastatin. However, association between serial plaque changes and LDL-cholesterol levels was not fully elucidated.
  
  
  METHODS
  A prospective, randomized, open-label trial.
  
  
  METHODS
  We investigated the long-term effect of 20 versus 5-mg atorvastatin on thoracic and abdominal plaques and the association between plaque progression and on-treatment LDL-cholesterol levels in 36 hypercholesterolemic patients. MRI was performed at baseline and 1 and 2 years of treatment. Vessel wall area change was evaluated.
  
  
  RESULTS
  The 20-mg dose markedly reduced LDL-cholesterol levels (-47%) versus 5-mg (-35%) dose. After 2 years of treatment, regression of thoracic plaques was found in the 20-mg group (-15% vessel wall area reduction), but not in the 5-mg group (+7%). Although the 20-mg dose induced plaque regression (-14%) from baseline to 1 year, no further regression was seen from 1 to 2 years of treatment (-1%). Regarding abdominal plaques, progression was found in the 5-mg group (+10%), but not in the 20-mg group (+2%). Plaque progression in the 5-mg group was found from baseline to 1 year (+8%), but not from 1 to 2 years (+2%). The degree of thoracic plaque regression correlated with LDL-cholesterol reduction (r = 0.61), whereas thoracic plaque change from 1 to 2 years correlated with on-treatment LDL-cholesterol levels (r = 0.64).
  
  
  CONCLUSIONS
  Twenty milligrams of atorvastatin regressed thoracic plaques. However, maintaining low LDL-cholesterol levels was needed to prevent plaque progression. In abdominal aorta, only retardation of plaque progression was found after 2 years of 20-mg treatment.
authors.affiliation: National Defense Medical College, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yonemura
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Momiyama
authors.forename: Zahi A
authors.initials: ZA
authors.lastname: Fayad
authors.forename: Makoto
authors.initials: M
authors.lastname: Ayaori
authors.forename: Reiko
authors.initials: R
authors.lastname: Ohmori
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Kihara
authors.forename: Nobukiyo
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nakaya
authors.forename: Masatsune
authors.initials: M
authors.lastname: Ogura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kusuhara
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nagata
authors.forename: Haruo
authors.initials: H
authors.lastname: Nakamura
authors.forename: Seiichi
authors.initials: S
authors.lastname: Tamai
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Ohsuzu
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000187:drug effects* / Q000473:pathology; D001013:Aorta, Thoracic / Q000187:drug effects* / Q000473:pathology; D001018:Aortic Diseases / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D001027:Aortography / Q000379:methods*; D050197:Atherosclerosis / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin