Circulation. 2002;106:2884-2887
Published online before print November 18, 2002, doi: 10.1161/01.CIR.0000041255.88750.F0
Published online before print November 18, 2002, doi: 10.1161/01.CIR.0000041255.88750.F0
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(Circulation. 2002;106:2884.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Lipid Lowering by Simvastatin Induces Regression of Human Atherosclerotic Lesions
Two Years’ Follow-Up by High-Resolution Noninvasive Magnetic Resonance Imaging
From the Cardiovascular Biology Research Laboratory (R.C., S.G.W., G.H., J.J.B.), The Cardiovascular Institute (R.C., V.F., Z.A.F., S.G.W., G.H., D.S., J. Wentzel, G.M., J.J.B.), and the Department of Neurology (J. Weinberger), Mount Sinai School of Medicine, New York, NY; and Merck Research Laboratories, Clinical Research, Endocrinology, and Metabolism (M.M.), Rathway, NJ.
Correspondence to Juan J. Badimon, PhD, Cardiovascular Biology Research Laboratory, Mount Sinai Medical School of Medicine, One Gustave Levy Place, PO Box 1030, New York, NY 10029. E-mail Juan.Badimon{at}mssm.edu
Background— Statins are widely used to treat hypercholesterolemia and atherosclerotic disease. Noninvasive MRI allows serial monitoring of atherosclerotic plaque size changes. Our aim was to investigate the effects of lipid lowering with simvastatin on atherosclerotic lesions.
Methods and Results— A total of 44 aortic and 32 carotid artery plaques were detected in 21 asymptomatic hypercholesterolemic patients at baseline. The effects of statin on these atherosclerotic lesions were evaluated as changes versus baseline in lumen area (LA), vessel wall thickness (VWT), and vessel wall area (VWA) by MRI. Maximal reduction of plasma total and LDL cholesterol by simvastatin (23% and 38% respectively; P<0.01 versus baseline) was achieved after 
6 weeks of therapy and maintained thereafter throughout the study. Significant (P<0.01) reductions in maximal VWT and VWA at 12 months (10% and 11% for aortic and 8% and 11% for carotid plaques, respectively), without changes in LA, have been reported. Further decreases in VWT and VWA ranging from 12% to 20% were observed at 18 and 24 months. A slight but significant increase (ranging from 4% to 6%) in LA was seen in both carotid and aortic lesions at these later time points.
Conclusion— The present study demonstrates that maintained lipid-lowering therapy with simvastatin is associated with significant regression of established atherosclerotic lesions in humans. Our observations indicate that lipid-lowering therapy is associated with sustained vascular remodeling and emphasize the need for longer-term treatment.
Key Words: lipids • atherosclerosis • plaque • magnetic resonance imaging
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