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Fighting Atherosclerosis: Recent Advances In Statin Therapy
Conquering Atherosclerosis - From Science to Clinical Practice - Sponsored by AstraZeneca
76th Congress of the European Atherosclerosis Society in Helsinki, Finland
June 11th, 2007
Vascular imaging techniques, such as quantitative coronary angiography,
intravascular ultrasound (IVUS), magnetic resonance imaging and B-mode
ultrasound, enable us to look inside the vessel wall and detect atherosclerotic
disease before the onset of clinical symptoms. Imaging of the vessels also allows the
monitoring of change in atherosclerotic burden over time to be evaluated.
Consequently, these techniques are useful in assessing the effects of interventions
such as lipid-lowering therapies on the atherosclerotic disease process.
Previously, angiography studies established an association between LDL cholesterol
(LDL-C) and atherosclerosis progression.1 Recently, a pooled analysis of four IVUS
trials demonstrated that increase in HDL cholesterol (HDL-C) level as well as an
intensive lowering of LDL-C were independent predictors of atheroma regression.2
In this meta-analysis, substantial regression3 (5% reduction in atheroma volume)
was observed in patients with LDL-C levels below the mean (87.5 mg/dL) and
percentage increases in HDL-C above the mean (7.5%).
The recent statin imaging trials have made a significant contribution to our
understanding of the benefits of statin therapy on the atherosclerotic disease
process. They demonstrate that slowing or delaying, and in some instances even
regression, of atheroma development can be achieved with effective treatment that
combines clinically relevant effects on HDL-C with intensive LDL-C lowering.
The effect of therapy on atherosclerosis may be a useful indicator of the impact of
interventions on clinical events. The strength of this hypothesis will be discussed.
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