Published online before print July 6, 2004, doi: 10.1161/01.CIR.0000135215.75876.41
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2004;110:265-270.)
© 2004 American Heart Association, Inc.
Original Articles |
Regression of Coronary Atherosclerosis by Simvastatin
A Serial Intravascular Ultrasound Study
From the Department of Cardiology, Odense University Hospital (L.O.J., P.T., K.E.P., T.H.), Odense, and the Department of Clinical Biochemistry, Gentofte Hospital (S.S.), Gentofte, Denmark.
Correspondence to Lisette Okkels Jensen, MD, PhD, Department of Cardiology, Catheterization Laboratorium, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense, Denmark. E-mail okkels{at}dadlnet.dk
Received November 6, 2003; de novo received January 7, 2004; revision received March 25, 2004; accepted March 29, 2004.
Background— Angiography of the coronary arteries reflects only changes in luminal dimensions. With intravascular ultrasound, cross-sectional images can be obtained and area measurements can be added to calculate volumes of the external elastic membrane (EEM), plaque plus media (P+M), and lumen. The aim of this study was to investigate the effect of lipid lowering by simvastatin on coronary atherosclerotic P+M as changes in volumes of EEM, P+M, and lumen.
Methods and Results— In 40 male patients with hypercholesterolemia, ischemic heart disease, and a nonsignificant coronary artery lesion in a not previously revascularized coronary artery, serial intravascular ultrasound studies with an ECG-triggered pullback were performed at baseline, after 3 months on a lipid-lowering diet, and after another 12 months on simvastatin 40 mg/d. Mean length of the analyzed atherosclerotic segments was 5.9±3.3 mm. After 12 months on simvastatin, a significant reduction in P+M volume of 6.3% (P=0.002) was observed, whereas only a nonsignificant reduction in EEM volume of 1.8% was seen without any concomitant change in lumen volume. A significant reduction in total cholesterol of 31.0% (6.1±0.8 versus 4.2±0.7 mmol/L, P<0.001) and LDL cholesterol of 42.6% (4.0±0.8 versus 2.2±0.6 mmol/L, P<0.001) was obtained.
Conclusions— Lipid-lowering therapy with simvastatin for 12 months is associated with a significant P+M regression in coronary arteries measured as reduction in P+M and EEM volumes without any concomitant change in lumen volume.
Key Words: atherosclerosis • plaque • remodeling • lipids • ultrasonics
This article has been cited by other articles:
 |
|
 |
|
  S. De Castro, E. Di Angelantonio, A. Celotto, M. Fiorelli, I. Passaseo, F. Papetti, S. Caselli, A. Marcantonio, A. Cohen, and N. Pandian Short-term evolution (9 months) of aortic atheroma in patients with or without embolic events: a follow-up transoesophageal echocardiographic study Eur J Echocardiogr, May 30, 2008; (2008) jen172v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Parolini, M. Marchesi, P. Lorenzon, M. Castano, E. Balconi, L. Miragoli, L. Chaabane, A. Morisetti, V. Lorusso, B. J. Martin, et al. Dose-related effects of repeated ETC-216 (recombinant apolipoprotein A-I Milano/1-palmitoyl-2-oleoyl phosphatidylcholine complexes) administrations on rabbit lipid-rich soft plaques: in vivo assessment by intravascular ultrasound and magnetic resonance imaging. J. Am. Coll. Cardiol., March 18, 2008; 51(11): 1098 - 1103. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Barlic and P. M. Murphy Chemokine regulation of atherosclerosis J. Leukoc. Biol., August 1, 2007; 82(2): 226 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Nicholls, E. M. Tuzcu, I. Sipahi, A. W. Grasso, P. Schoenhagen, T. Hu, K. Wolski, T. Crowe, M. Y. Desai, S. L. Hazen, et al. Statins, High-Density Lipoprotein Cholesterol, and Regression of Coronary Atherosclerosis JAMA, February 7, 2007; 297(5): 499 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. N. Boushra and M. Muntazar Review article: The role of statins in reducing perioperative cardiac risk: physiologic and clinical perspectives: [Le role des statines dans la reduction du risque cardiaque perioperatoire : perspectives physiologiques et cliniques]. Can J Anesth, November 1, 2006; 53(11): 1126 - 1147. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Crouse III Thematic review series: Patient-Oriented Research. Imaging atherosclerosis: state of the art J. Lipid Res., August 1, 2006; 47(8): 1677 - 1699. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hartmann, C. von Birgelen, G. S. Mintz, M. G. Stoel, H. Eggebrecht, H. Wieneke, M. Fahy, T. Neumann, J. van der Palen, H. W. Louwerenburg, et al. Relation Between Lipoprotein(a) and Fibrinogen and Serial Intravascular Ultrasound Plaque Progression in Left Main Coronary Arteries J. Am. Coll. Cardiol., August 1, 2006; 48(3): 446 - 452. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Hartmann, C. von Birgelen, G. S. Mintz, P. M.J. Verhorst, and R. Erbel Relation between baseline plaque burden and subsequent remodelling of atherosclerotic left main coronary arteries: a serial intravascular ultrasound study with long-term (>=12 months) follow-up Eur. Heart J., August 1, 2006; 27(15): 1778 - 1784. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Johnson, D. A. Dowe, T. M. Catanzano, and J. A. Brink Regression of coronary atherosclerotic plaque as shown by CT arteriography. Am. J. Roentgenol., August 1, 2006; 187(2): W241 - W241. [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Nicholls, E. M. Tuzcu, I. Sipahi, P. Schoenhagen, and S. E. Nissen Intravascular Ultrasound in Cardiovascular Medicine Circulation, July 25, 2006; 114(4): e55 - e59. [Full Text] [PDF]
|
|
|
|
|
|
S. E. Nissen, S. J. Nicholls, I. Sipahi, P. Libby, J. S. Raichlen, C. M. Ballantyne, J. Davignon, R. Erbel, J. C. Fruchart, J.-C. Tardif, et al. Effect of Very High-Intensity Statin Therapy on Regression of Coronary Atherosclerosis: The ASTEROID Trial JAMA, April 5, 2006; 295(13): 1556 - 1565. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Raggi, A. Taylor, Z. Fayad, D. O'Leary, S. Nissen, D. Rader, and L. J. Shaw Atherosclerotic Plaque Imaging: Contemporary Role in Preventive Cardiology Arch Intern Med, November 14, 2005; 165(20): 2345 - 2353. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Corti, V. Fuster, Z. A. Fayad, S. G. Worthley, G. Helft, W. F. Chaplin, J. Muntwyler, J. F. Viles-Gonzalez, J. Weinberger, D. A. Smith, et al. Effects of Aggressive Versus Conventional Lipid-Lowering Therapy by Simvastatin on Human Atherosclerotic Lesions: A Prospective, Randomized, Double-Blind Trial With High-Resolution Magnetic Resonance Imaging J. Am. Coll. Cardiol., July 5, 2005; 46(1): 106 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kawasaki, K. Sano, M. Okubo, H. Yokoyama, Y. Ito, I. Murata, K. Tsuchiya, S. Minatoguchi, X. Zhou, H. Fujita, et al. Volumetric Quantitative Analysis of Tissue Characteristics of Coronary Plaques After Statin Therapy Using Three-Dimensional Integrated Backscatter Intravascular Ultrasound J. Am. Coll. Cardiol., June 21, 2005; 45(12): 1946 - 1953. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Wentzel, R. Corti, Z. A. Fayad, P. Wisdom, F. Macaluso, M. O. Winkelman, V. Fuster, and J. J. Badimon Does shear stress modulate both plaque progression and regression in the thoracic aorta?: Human study using serial magnetic resonance imaging J. Am. Coll. Cardiol., March 15, 2005; 45(6): 846 - 854. [Abstract] [Full Text] [PDF]
|
|