Reverse Artery Plaque With Medications

Cholesterol drugs reduce plaque in clogged arteries and reverse coronary artery disease progression

(RxWiki News) Large doses of common cholesterol-lowering medications appear to reverse coronary artery disease by reducing the amount of plaque in clogged arteries.

Taking a 40 milligram dose of rosuvastatin (Crestor) or an 80 milligram dose of atorvastatin (Lipitor) had the effect of reversing plaque formation, scientists found.

"Take cholesterol medication only as prescribed by your doctor."

Dr. Stephen J. Nicholls, lead researcher and cardiovascular director of the Cleveland Clinic Coordinating Center for Clinical Research, noted that regression of plaque is the holy grail of heart disease treatment. He said that more than two-thirds of patients in the trial showed regression.

Researchers followed 1,385 patients from 215 centers during the SATURN (Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin) trial, a large study using intracoronary ultrasound to measure changes in the amount of plaque in coronary arteries.

Over a two year period, investigators studied the effects of rosuvastatin and atorvastatin in lowering bad LDL cholesterol as well as their effect on good HDL cholesterol. Previous trials found that high doses of rosuvastatin increased HDL cholesterol 7 percent to 15 percent, while atorvastatin had little effect on good cholesterol.

Participants previously had a coronary angiography, most commonly following chest pain or an abnormal stress test. In other studies where patients took lower doses of the same drugs, up to 20 percent of patients suffered a heart attack or stroke, or required angioplasty to clear a clogged artery. During the SATURN trial, only about half as many patients reported adverse cardiac events.

SATURN trial researchers found that the amount of artery plaque in the section of the coronary artery that was assessed was reduced by .99 percent with atorvastatin and 1.22 percent with rosuvastatin. The difference was not considered statistically significant. Atorvastatin lowered plaque in 65 percent of participants, while rosuvastatin reduced plaque in 71 percent of  patients.

“Doctors have been reluctant to use high doses of statins, but in this study the drugs were safe, well tolerated and had a profound impact on lipid levels, the amount of plaque in vessel walls and the number of cardiovascular events,” Dr. Nicholls said.

The study was presented today at the American Heart Association's annual meeting in Orlando, Fla. and also simultaneously published in the New England Journal of Medicine.

Review Date: 
November 15, 2011