title: Long-term changes in serum cholesterol level does not influence the progression of coronary calcification.
abstract: 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.
authors.affiliation: Cardiac Rehabilitation Institute, the Chaim Sheba Medical Center, Tel-Hashomer, Israel. altenen@yahoo.com
authors.forename: Alexander
authors.initials: A
authors.lastname: Tenenbaum
authors.forename: Joseph
authors.initials: J
authors.lastname: Shemesh
authors.forename: Nira
authors.initials: N
authors.lastname: Koren-Morag
authors.forename: Enrique Z
authors.initials: EZ
authors.lastname: Fisman
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Adler
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.forename: David
authors.initials: D
authors.lastname: Tanne
authors.forename: Ilan
authors.initials: I
authors.lastname: Hay
authors.forename: Ehud
authors.initials: E
authors.lastname: Schwammenthal
authors.forename: Michael
authors.initials: M
authors.lastname: Motro
mesh_terms: 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
chemical_list: D015415:Biomarkers; D002784:Cholesterol