title: Regression of coronary atheroma with statin therapy.
abstract: OBJECTIVE
  This article reviews coronary atheroma regression with statin therapy.
  
  
  RESULTS
  Unlocking the mechanisms of atherogenesis and plaque progression has been fundamental to understanding the means by which contemporary antiatherosclerotic therapies lower cardiovascular risk. The advent of intracoronary imaging has helped chart the natural course of coronary atherosclerosis and evaluate therapeutic strategies that modify its natural progression. From earlier intravascular ultrasonography studies using lower dose statins to recent clinical trials evaluating the long-term effects of high-intensity statin therapies, our understanding of the relationship between incremental low-density lipoprotein-cholesterol lowering and coronary atheroma progression-regression has evolved considerably, particularly in patients of varying cardiometabolic risk including those with diabetes mellitus and acute coronary syndromes. Evaluating the impact of novel therapies on coronary atheroma using imaging will continue to be integral in establishing their mechanistic benefit prior to embarking on large-scale, expensive, long-duration randomized trials powered for clinical end points.
  
  
  CONCLUSIONS
  Statins have remarkably impacted the natural course of coronary atherogenesis. Intravascular imaging has proven crucial in evaluating the mechanisms by which we can curb coronary atheroma progression and induce its regression. The insights gleaned from intravascular imaging trials evaluating statins have been complementary to the findings from large-scale trials powered for clinical end points.
authors.affiliation: aDepartment of Cardiovascular Medicine, Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland Clinic, Cleveland, Ohio, USA bQuébec Heart and Lung Institute, Hôpital Laval, Québec, Canada cDepartment of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Mohamed B
authors.initials: MB
authors.lastname: Elshazly
authors.forename: Brian
authors.initials: B
authors.lastname: Stegman
authors.forename: Rishi
authors.initials: R
authors.lastname: Puri
mesh_terms: D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D058226:Plaque, Atherosclerotic; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids