The effect of statins on carotid intima-media thickness in patients with acute coronary syndrome

Background: Statins have been established by definitive primary and secondary cardiovascular prevention trials as the cornerstone of pharmacy prevention of atherosclerotic vascular disease. Carotid arterial intima-media thickness is used as a noninvasive surrogate end point in epidemiologic studies and clinical trials to gauge progression and regression of atherosclerosis. In this trial, we compared the effects of a high-potency statin with different dose (atorvastatin 20 mg/d and atorvastatin 40 mg/d) on carotid intima-media thickness (CIMT). Methods: This was a randomized, single blinded clinical trial that performed on 100 patients with ACS diagnosis from April 2014 to September 2015. The effects of atorvastatin (20 mg/d; n=50) and atorvastatin (40 mg/d; n=50) on CIMT were compared using serial assessment of the thickness of common carotid artery. Results: The mean patient age was 52 years and 74% were male. Baseline CIMT and other characteristics were similar between study groups. CIMT was stable in the both study groups after 6 months and there were no meaningful statistical differences observed between study groups (change in CIMT, 0.044±0.169 and -0.006±0.168 mm; p=0.14). Conclusions: This comparative trial shows that the use of atorvastatin 20 mg/d and 40 mg/d in short term have similar effects on carotid intima-media thickness. However, intensive statin therapy may have been shown to yield improvement in atherosclerosis with measurement of the carotid intima-media thickness.