Long-term changes in serum cholesterol level does not influence the progression of coronary calcification.
BACKGROUND
A number of reports controversially describe the influence of cholesterol level and lipid-lowering treatment (LLT) on the progression of coronary calcium (CC). We tested the hypothesis that long-term changes in serum cholesterol (CL) would affect the progression of CC.


METHODS
The study population comprised 510 patients with stable angina pectoris, mean age of 63 ± 9 years. At baseline 372 patients received statin and/or fibrate (LLT group) while 138 patients did not (No-LLT at baseline group). Spiral CT every 24 months was used to track the progression of CC over a median 5.6 year follow-up.


RESULTS
CL decreased during follow-up in both groups, but more pronouncedly in patients with LLT. The changes in total calcium score (TCS) were similar in both groups (p=0.3). Changes in CL during follow-up were not associated with CC: TCS increased by 501 ± 63 from baseline in the 1st (upper) quartile, and by 350 ± 44, 403 ± 41 and 480 ± 56 in the 2nd, 3rd, and 4th quartiles of CL longitudinal changes (p = 0.2), respectively. Baseline TCS and its changes were not correlated with baseline CL and its changes. New calcified lesions were diagnosed in 132 (28.2%) out of the 467 patients available for this analysis, without significant difference between groups (p=0.4). Multivariate analysis demonstrated that only baseline TCS (p < 0.001), body mass index (p = 0.007) and age (p = 0.006) were independent predictors for the TCS changes.


CONCLUSIONS
Longitudinal CL changes do not seem to have a measurable effect on the rate of progression of CC.
Tenenbaum
Alexander
A
Cardiac Rehabilitation Institute, the Chaim Sheba Medical Center, Tel-Hashomer, Israel. altenen@yahoo.com
Shemesh
Joseph
J
Koren-Morag
Nira
N
Fisman
Enrique Z
EZ
Adler
Yehuda
Y
Goldenberg
Ilan
I
Tanne
David
D
Hay
Ilan
I
Schwammenthal
Ehud
E
Motro
Michael
M
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002114:Calcinosis / Q000097:blood* / Q000175:diagnosis; D002784:Cholesterol / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D015415:Biomarkers; D002784:Cholesterol