Statins moderate coronary stenoses but not coronary calcification: results from meta-analyses.
BACKGROUND
Coronary artery stenoses have been shown in various trials to be moderated by treatment with statins. A similar effect on coronary artery calcification has not been demonstrated. We therefore undertook meta-analyses of trials examining the effect of statin treatment on coronary artery stenoses and coronary artery calcification.


METHODS
Literature searches identified five controlled trials suitable for inclusion in the analysis of the effect of statins (high dose versus either low dose or placebo) on coronary artery calcification and six trials suitable for inclusion in the analysis of the effect of statins on coronary artery stenoses.


RESULTS
All trials reported substantial and significant reductions in LDL-C with statin treatment which results in net reductions of LDL-C in the CAC and coronary stenoses trials of 1.0 mmol/L and 0.9 mmol/L, respectively. Analysis of the CAC trials did not demonstrate any effect of statins on the progression of calcification. In contrast, in the coronary stenoses trials there was a consistent moderation of stenosis severity progression with statins (p<0.0001).


CONCLUSIONS
Meta-analyses of the available trials have demonstrated a significant moderation of coronary stenoses associated with the statin-induced reduction in LDL-C. In contrast, there was no effect on coronary calcification despite a similar reduction in LDL-C levels. This suggests that the pathogenesis of the two conditions may be different, if not in aetiology, then certainly in their development. It further suggests that statin use to moderate arterial calcification is not effective.
Henein
Michael Y
MY
Heart Centre and Department of Public Health and Clinical Medicine, Umea University, Sweden. Michael.henein@medicin.umu.se
Owen
Andrew
A
D002114:Calcinosis / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D009202:Cardiomyopathies / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood; D023921:Coronary Stenosis / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000379:methods
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors