Effect of lipid-lowering therapy with atorvastatin on atherosclerotic aortic plaques: A 2-year follow-up by noninvasive MRI

Atsushi Yonemura, Yukihiko Momiyama, Zahi A. Fayad, Makoto Ayaori, Reiko Ohmori, Teruyoshi Kihara, Nobukiyo Tanaka, Kazuhiro Nakaya, Masatsune Ogura, Hiroaki Taniguchi, Masatoshi Kusuhara, Masayoshi Nagata, Haruo Nakamura, Seiichi Tamai, Fumitaka Ohsuzu

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Using MRI, we reported plaque regression in thoracic aorta and retardation of plaque progression in abdominal aorta by 1-year atorvastatin. However, association between serial plaque changes and LDL-cholesterol levels was not fully elucidated. A prospective, randomized, open-label trial. We investigated the long-term effect of 20 versus 5-mg atorvastatin on thoracic and abdominal plaques and the association between plaque progression and on-treatment LDL-cholesterol levels in 36 hypercholesterolemia patients. MRI was performed at baseline and 1 and 2 years of treatment. Vessel wall area change was evaluated. The 20-mg dose markedly reduced LDL-cholesterol levels (−47%) versus 5-mg (−35%) dose. After 2 years of treatment, regression of thoracic plaques was found in the 20-mg group (−15% vessel wall area reduction), but not in the 5-mg group (+7%). Although the 20-mg dose induced plaque regression (−14%) from baseline to 1 year, no further regression was seen from 1 to 2 years of treatment (−1%). Regarding abdominal plaques, progression was found in the 5-mg group (+10%), but not in the 20-mg group (+2%). Plaque progression in the 5-mg group was found from baseline to 1 year (+8%), but not from 1 to 2 years (+2%). The degree of thoracic plaque regression correlated with LDL-cholesterol reduction (r = 0.61), whereas thoracic plaque change from 1 to 2 years correlated with on-treatment LDL-cholesterol levels (r = 0.64). Twenty milligrams of atorvastatin regressed thoracic plaques. However, maintaining low LDL-cholesterol levels was needed to prevent plaque progression. In abdominal aorta, only retardation of plaque progression was found after 2 years of 20-mg treatment.

Original languageEnglish
Pages (from-to)222-228
Number of pages7
JournalEuropean Journal of Preventive Cardiology
Volume16
Issue number2
DOIs
StatePublished - Apr 2009

Keywords

  • MRI
  • aorta
  • atherosclerotic plaque
  • lipid-lowering

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