title: A systematic review of the time course of atherosclerotic plaque regression.
abstract: OBJECTIVE
  We sought to determine the time required for lipid treatment to produce regression of atherosclerotic plaques.
  
  
  BACKGROUND
  The cholesterol content of atherosclerotic plaques contributes to their instability, and most acute cardiac events including myocardial infarction and sudden death are produced by coronary plaque disruption. We systematically reviewed the literature on atherosclerosis regression to identify the time required for cholesterol egress, plaque regression, and possible plaque stabilization. Such information may help decide when patients with statin side effects or other reasons for statin discontinuation could consider a reduction in the intensity of treatment.
  
  
  METHODS
  We performed a PubMed search to identify English language articles reporting atherosclerotic regression. Articles pertinent to the topic were reviewed in detail.
  
  
  RESULTS
  We identified 189 articles, 50 of which provided sufficient information to establish a rate of regression and 31 of which demonstrated plaque regression with statin therapy in the carotid (n = 11), coronary (n = 16), and aortic (n = 4) vascular beds. Plaque regression occurred after an average of 19.7 months of treatment.
  
  
  CONCLUSIONS
  Regression of atherosclerotic plaque using statin therapy in those studies documenting regression occurred after an average time of 19.7 months. This suggests that patients should undergo approximately two years of aggressive lipid reduction before considering a reduction of statin therapy.
authors.affiliation: Department of Medicine, University of Connecticut Medical School, Farmington, CT, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Noyes
authors.affiliation: Division of Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA. Electronic address: paul.thompson@hhchealth.org.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Thompson
mesh_terms: D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D058226:Plaque, Atherosclerotic / Q000188:drug therapy*; D012074:Remission Induction; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Atherosclerosis; Regression; Statins