All entries tagged with “statin”

Fight Back The Plaque

Posted by Dr. Micah Eimer on Monday Dec 05, 2011 1:54 pm

When patients are diagnosed with atherosclerotic disease (plaque in the arteries) they frequently ask me if this can ever get better.  A new study published in the New England Journal of Medicine sheds some light on this subject.

 Investigators from the Cleveland Clinic studied over 1,000 patients with coronary artery disease using a tiny ultrasound probe which fits inside coronary arteries and can measure the amount of plaque very accurately.  Patients underwent an initial measurement of their “plaque burden” and then were randomized to one of two statin medications – either atorvastatin (Lipitor) 80mg daily or rosuvastatin (Crestor) 40mg daily.  The ultrasound was then repeated about two years later to see if there was any change in the plaque levels.

 At the beginning of the trial, the patients in both  groups had an average LDL (bad cholesterol) of 120mg/dL. After two years of therapy the LDL had gone down significantly – the Lipitor group had an LDL of  70mg/dL and the Crestor group was slightly lower at 63 mg/dL.  The HDL (good cholesterol) was 45mg/dL in both groups to start and increased to 49mg/dL in the Lipitor group and 50mg/dL in the Crestor group.

 Regarding the amount of plaque in the coronary arteries, both groups saw an average decrease in the amount of plaque by about 1%.  Looking at it another way, 63% of the patients in the Lipitor group and 69% of patients in the Crestor group had regression of their plaque burden in the coronary artery.

Despite the high doses of powerful cholesterol lowering medications, the incidence of side effects was quite low. Nonetheless approximately  20% of patients in both groups discontinued the study medication.

 It should be noted that this study was not able to prove that reducing plaque results in less heart attack, stroke or death. However, it is encouraging to know that the majority of patients that achieve an LDL less than 70mg/dL using Crestor or Lipitor will experience a regression of their atherosclerosis.

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