Key result
One year of atorvastatin therapy significantly reduced mean noncalcified coronary plaque volume from 0.042 mL to 0.030 mL (P<0.05) in men with elevated cardiovascular risk.
Why the study?
Does atorvastatin 20 mg reduce coronary plaque burden in men with elevated CAD risk?
Observational (n=46)
Does atorvastatin 20 mg reduce coronary plaque burden in men with elevated CAD risk?
Answers are grounded in this paper and cite their sources.
Atorvastatin therapy significantly reduces noncalcified coronary plaque volume in high-risk men, despite no change in calcium score or total plaque burden.
PURPOSE: Multislice detector computed tomography (MSCT) is an accurate noninvasive modality to detect and classify different stages of atherosclerosis. The aim of the New Age II Study was to detect coronary lesions in men without established coronary artery disease (CAD) but with a distinct cardiovascular risk profile. We also sought to assess the effect after 1 year of a lipid-lowering therapy (LLT) using 20 mg of atorvastatin. METHODS: Forty-sixe male patients (mean, 61 +/- 10 years) with an elevated risk for CAD (PROCAM score >3 quintile) without LLT were included. Native and contrast-enhanced scans were performed in all patients. A total of 27 of 46 patients received a follow-up scan (after 488 +/- 138 days). Coronary plaque burden (CPB) was assessed volumetrically. RESULTS: The prevalence of CAD was 83% (38/46 patients), and 11% (5/46) without coronary calcifications still had noncalcified plaques. Total cholesterol and low-density lipoprotein cholesterol levels decreased significantly under LLT (225 +/- 41 mg/dL vs. 162 +/- 37 mg/dL, P < 0.0001 and 148 +/- 7 mg/dL vs. 88 +/- 5 mg/dL, P < 0.001, respectively). On follow-up, calcium score and CPB remained unchanged (Agatston score: 261 +/- 301 vs. 282 +/- 360; CPB: 0.149 +/- 0.108 vs. 0.128 +/- 0.075 mL, P > 0.05), whereas mean plaque volume of noncalcified plaques decreased significantly from 0.042 +/- 0.029 mL versus 0.030 +/- 0.014 mL (P < 0.05, mean reduction 0.012 +/- 0.017 mL or 24 +/- 13%). CONCLUSIONS: Statin therapy led to a significant reduction of noncalcified plaque burden that was not reflected in calcium scoring or total plaque burden. This finding might explain the risk reduction after the initiation of statin therapy. Using multislice detector computed tomography, physicians have the potential to monitor medical treatment in patients with coronary atherosclerosis.
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Burgstahler et al. (2007) conducted an observational in Elevated risk for coronary artery disease (n=46). Atorvastatin vs. Baseline was evaluated on Mean plaque volume of noncalcified plaques (mean reduction 0.012 mL, p=<0.05). One year of atorvastatin therapy significantly reduced mean noncalcified coronary plaque volume from 0.042 mL to 0.030 mL (P<0.05) in men with elevated cardiovascular risk.
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