Cholesterol Drug Assessment 2.0

MRI scans may be useful in monitoring how well cholesterol drugs are working

(RxWiki News) Doctors generally monitor how well cholesterol lowering drugs are working through simple blood tests. A high tech method that uses MRI scanning may let them peek inside the arteries to evaluate drug effectiveness.

Imaging has long been available to monitor plaque build up when evaluating patients for heart disease. Now researchers say a more precise MRI scan can show the amount of cholesterol within that plaque. If followed up with intense treatment, the amount of cholesterol could be significantly reduced.

"Ask your physician or pharmacist if your drugs are working."

Dr. Binh An P. Phan, a co-author and cardiologist with Loyola University Health System, said MRI scanning could become a powerful tool for assessing cholesterol drugs.

Researchers enrolled 120 patients with high cholesterol at the University of Washington. Participants were randomly assigned to take one of three cholesterol treatments: Lipitor (atorvastatin), Lipitor plus Niaspan (niacin) or Lipitor with Niaspan and Colesevelam (welchol).

Patients were monitored through MRI imaging of the carotid arteries in the neck since these arteries are easier to capture in images because of their proximity to the surface and because coronary arteries tend to move.

After a period of three years, the 33 patients with identified carotid plaques had a significant cholesterol reduction within the plaque, with the percentage of the plaque volume consisting of cholesterol dropping from 14 percent to 7 percent.

The findings confirmed the suspicions of researchers in that the reason cholesterol drugs shrink the overall size of plaque is because cholesterol is being removed from the plaque.  Researchers concluded that regularly monitoring the amount of cholesterol in plaque could help doctors determine how well cholesterol medication is working, allowing them to try more aggressive therapy if the amount of cholesterol is not diminishing.

Researchers called the study a first step and said that additional studies of the tool will be needed.

The study was funded by the National Heart, Lung and Blood Institute, and Pfizer Inc., which markets Lipitor. The research was published in the Journal of the American College of Cardiology: Cardiovascular Imaging.

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Review Date: 
October 21, 2011