This Article Free upon publication Full Text Full Text (PDF) All Versions of this Article: 117/19/2458    most recent CIRCULATIONAHA.108.773747v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ballantyne, C. M. Search for Related Content PubMed PubMed Citation Articles by Ballantyne, C. M. Related Collections Lipids Coronary imaging: angiography/ultrasound/Doppler/CC Chronic ischemic heart disease

(Circulation. 2008;117:2458-2466.)
© 2008 American Heart Association, Inc.

Coronary Heart Disease

Effect of Rosuvastatin Therapy on Coronary Artery Stenoses Assessed by Quantitative Coronary Angiography

A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden

Christie M. Ballantyne, MD; Joel S. Raichlen, MD; Stephen J. Nicholls, MBBS, PhD; Raimund Erbel, MD; Jean-Claude Tardif, MD; Sorin J. Brener, MD; Valerie A. Cain, MS; Steven E. Nissen, MD, for the ASTEROID Investigators

From the Section of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, Tex (C.M.B.); AstraZeneca, Wilmington, Del (J.S.R., V.A.C.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio (S.J.N., S.J.B., S.E.N.); Department of Cardiology, University Clinic Essen, Essen, Germany (R.E.); and Montreal Heart Institute, Montreal, Quebec, Canada (J.-C.T.).

Correspondence to Christie M. Ballantyne, MD, Baylor College of Medicine, 6565 Fannin St, MS A601, Ste A656, Houston, TX 77030. E-mail cmb{at}bcm.tmc.edu

Received February 15, 2008; accepted March 19, 2008.

Background— Previous studies using quantitative coronary angiography have demonstrated that statin therapy slows the progression of coronary stenoses in proportion to average low-density lipoprotein cholesterol levels during therapy. However, no major statin monotherapy study has demonstrated either halted progression or regression of angiographic disease. A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden (ASTEROID) assessed whether rosuvastatin could regress coronary atherosclerosis by intravascular ultrasound and quantitative coronary angiography. Intravascular ultrasound showed atheroma volume regression in a single coronary artery with <50% angiographic luminal narrowing.

Methods and Results— ASTEROID treated 507 coronary disease patients with rosuvastatin 40 mg/d for 24 months. Blinded quantitative coronary angiography analyses of percent diameter stenosis and minimum lumen diameter were performed for up to 10 segments of coronary arteries and major branches with >25% diameter stenosis at baseline. For each patient, the mean of all matched lesions at baseline and study end was calculated. There were 292 patients with 613 matched stenoses. Rosuvastatin reduced low-density lipoprotein cholesterol by 53.3% to 61.1±20.3 mg/dL and increased high-density lipoprotein cholesterol by 13.8% to 48.3±12.4 mg/dL. Mean±SD percent diameter stenosis decreased from 37.3±8.4% (median, 35.7%; range, 26% to 73%) to 36.0±10.1% (median, 34.5%; range, 8% to 74%; P<0.001). Minimum lumen diameter increased from 1.65±0.36 mm (median, 1.62 mm; range, 0.56 to 2.65 mm) to 1.68±0.38 mm (median, 1.67 mm; range, 0.76 to 2.77 mm; P<0.001).

Conclusions— Rosuvastatin treatment for 24 months to average low-density lipoprotein cholesterol levels well below 70 mg/dL, accompanied by significant increases in high-density lipoprotein cholesterol, produced regression by decreasing percent diameter stenosis and improving minimum lumen diameter as measured by quantitative coronary angiography in coronary disease patients.

---

 

CLINICAL PERSPECTIVE

This article has been cited by other articles:

				C. M. Gibson, Y. B. Pride, C. P. Hochberg, S. Sloan, M. S. Sabatine, C. P. Cannon, and for the TIMI Study Group Effect of Intensive Statin Therapy on Clinical Outcomes Among Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome: PCI-PROVE IT: A PROVE IT-TIMI 22 (Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction 22) Substudy J. Am. Coll. Cardiol., December 8, 2009; 54(24): 2290 - 2295. [Abstract] [Full Text] [PDF]

				J. Rodes-Cabau, O. F. Bertrand, E. Larose, J.-P. Dery, S. Rinfret, R. Bagur, G. Proulx, C. M. Nguyen, M. Cote, M.-C. Landcop, et al. Comparison of Plaque Sealing With Paclitaxel-Eluting Stents Versus Medical Therapy for the Treatment of Moderate Nonsignificant Saphenous Vein Graft Lesions: The Moderate VEin Graft LEsion Stenting With the Taxus Stent and Intravascular Ultrasound (VELETI) Pilot Trial Circulation, November 17, 2009; 120(20): 1978 - 1986. [Abstract] [Full Text] [PDF]

				J. H. O'Keefe, M. D. Carter, and C. J. Lavie Primary and Secondary Prevention of Cardiovascular Diseases: A Practical Evidence-Based Approach Mayo Clin. Proc., August 1, 2009; 84(8): 741 - 757. [Abstract] [Full Text] [PDF]

				J. Sanz, P. R. Moreno, and V. Fuster The year in atherothrombosis. J. Am. Coll. Cardiol., April 14, 2009; 53(15): 1326 - 1337. [Full Text] [PDF]

				M. C. Meuwese, E. de Groot, R. Duivenvoorden, M. D. Trip, L. Ose, F. J. Maritz, D. C. G. Basart, J. J. P. Kastelein, R. Habib, M. H. Davidson, et al. ACAT Inhibition and Progression of Carotid Atherosclerosis in Patients With Familial Hypercholesterolemia: The CAPTIVATE Randomized Trial JAMA, March 18, 2009; 301(11): 1131 - 1139. [Abstract] [Full Text] [PDF]

				A. Riad, S. Bien, D. Westermann, P. M. Becher, K. Loya, U. Landmesser, H. K. Kroemer, H. P. Schultheiss, and C. Tschope Pretreatment with Statin Attenuates the Cardiotoxicity of Doxorubicin in Mice Cancer Res., January 15, 2009; 69(2): 695 - 699. [Abstract] [Full Text] [PDF]

				H. Kaneda Letter by Kaneda Regarding Article, "Effect of Rosuvastatin Therapy on Coronary Artery Stenoses Assessed by Quantitative Coronary Angiography: A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden" Circulation, November 25, 2008; 118(22): e706 - e706. [Full Text] [PDF]

				B. S. Sutton, R. S. Blumenthal, and N. K. Kapur Letter by Sutton et al Regarding Article, "Effect of Rosuvastatin Therapy on Coronary Artery Stenoses Assessed by Quantitative Coronary Angiography: A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden" Circulation, November 25, 2008; 118(22): e707 - e707. [Full Text] [PDF]

				C. M. Ballantyne, J. S. Raichlen, V. A. Cain, S. J. Nicholls, S. E. Nissen, R. Erbel, J.-C. Tardif, and S. J. Brener Response to Letters Regarding Article, "Effect of Rosuvastatin Therapy on Coronary Artery Stenoses Assessed by Quantitative Coronary Angiography: A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden" Circulation, November 25, 2008; 118(22): e708 - e708. [Full Text] [PDF]

				A. Efthimiadis Rosuvastatin and Cardiovascular Disease: Did the Strongest Statin Hold the Initial Promises? Angiology, August 1, 2008; 59(2_suppl): 62S - 64S. [Abstract] [PDF]