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Does Statin Therapy Affect the Progression of Atherosclerosis Measured by a Coronary Calcium Score?

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Abstract

Coronary atherosclerosis is a leading cause of death in the United States and worldwide, accounting for close to 1 million deaths annually in the United States alone. The evaluation of coronary disease by CT-derived calcium scores is a rapidly evolving field of medical imaging. Furthermore, until recently, whether or not regression or progression of coronary disease could accurately be assessed by coronary calcium scores had been a question of considerable debate among experts in this field. If the medical treatment of coronary artery disease by statin pharmacotherapy could be accurately assessed by coronary calcium scoring, this would take much of the current guess work out of statin pharmacotherapy. Initial retrospective studies and observational data suggested that statin treatment resulted in reduction of coronary calcium. More recently, five randomized controlled trials have demonstrated that not only does statin treatment not reduce coronary calcium, but in fact, the progression of coronary calcium by CT scanning is indistinguishable from placebo treatment.

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References

Papers of particular interest, published recently, have been highlighted as:•• Of major importance

  1. Mao SS, Pal RA, McKay CR, et al.: Comparison of coronary artery calcium between electron beam computed tomography and 64-multidetector computed tomographic scanner. J Comput Assist Tomog 2009, 2:175–178

    Article  Google Scholar 

  2. Schoepf UJ, Becker CR, Ohnesorge BM, et al.: CT of coronary artery disease. Radiology 2004, 232:18–37

    Article  PubMed  Google Scholar 

  3. Rumberger JA: Role of noninvasive imaging using computed tomography for detection and quantification of coronary atherosclerosis. Future Cardiol 2008, 3:269–283

    Article  Google Scholar 

  4. Agatston AS, Janowitz WR, Hildner FJ, et al.: Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990, 15:827–832

    Article  CAS  PubMed  Google Scholar 

  5. Callister TQ, Raggi P, Cooil B, et al.: Effect of HMG-CoA reductase inhibitors on coronary artery disease as assessed by electron-beam computed tomography. N Engl J Med 1998, 339:1972–1978

    Article  CAS  PubMed  Google Scholar 

  6. Achenbach S, Ropers D, Pohle K, et al.: Influence of lipid-lowering therapy on the progression of coronary artery calcification. Circulation 2002, 106:1077–1082

    Article  CAS  PubMed  Google Scholar 

  7. Arad Y, Spadaro LA, Roth M, et al.: Treatment of asymptomatic adults with elevated coronary calcium scores with atorvastatin, vitamin C, and vitamin E. J Am Coll Cardiol 2005, 46:166–172

    Article  CAS  PubMed  Google Scholar 

  8. Raggi P, Davidson M, Callister TQ, et al.: Aggressive versus moderate lipid-lowering therapy in hypercholesterolemic postmenopausal women. Circulation 2005, 112:563–571

    Article  CAS  PubMed  Google Scholar 

  9. Schmermund A, Achenbach S, Budde T, et al.: Effect of intensive versus standard lipid-lowering treatment with atorvastatin on the progression of calcified coronary atherosclerosis over 12 months. Circulation 2006, 113:427–437

    Article  CAS  PubMed  Google Scholar 

  10. Hously ED, Cowell SJ, Prescott RJ, et al.: Progressive coronary calcification despite intensive lipid-lowering treatment: a randomized controlled trial. Heart 2006, 92:1207–1212.

    Article  CAS  Google Scholar 

  11. •• Terry JG, Carr JJ, Koub EO, et al.: Effect of simvastatin (80 mg) on coronary and abdominal aortic arterial calcium (from the Coronary Artery calcification Treatment with Zocor (CATZ) study). Am J Cardiol 2007, 99:1714–1717. This was a placebo-controlled study designed exclusively to follow coronary and aortic calcification.

    Article  CAS  PubMed  Google Scholar 

  12. Mohler ER, Wang H, Medenilla E, et al.: Effect of statin treatment on aortic valve and coronary artery calcification. J Heart Valve Dis 2007, 16:378–386

    PubMed  Google Scholar 

  13. Uehara M, Funabashi N, Mikami Y, et al.: Quantitative effect of atorvastatin on size and content of non-calcified plaques of coronary arteries 1 year after atorvastatin treatment by multislice computed tomography. Int J Cardiol 2008, 130:269–275.

    Article  PubMed  Google Scholar 

  14. Knollmann FD, Stuhmer F, Lehmkuhl H: Progression of coronary atherosclerosis after heart transplantation on electron-beam computed tomography. Acad Radiol 2009, 16:194–199.

    Article  PubMed  Google Scholar 

  15. Nicholls SJ, Tuzcu EM, Wolski K, et al.: Coronary artery calcification and changes in atheroma burden in response to established medical therapies. J Am Coll Cardiol 2007, 49:263–270.

    Article  PubMed  Google Scholar 

  16. Nissen SE, Tuzcu EM, Lippy P, et al.: Effect of antihypertensive agents on cardiovascular events in patients with acute coronary syndromes: a randomized controlled trial. JAMA 2003, 290:2292–2300.

    Article  CAS  PubMed  Google Scholar 

  17. Nissen SE, Tuzcu EM, Schoenhagen P, et al.: Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA 2004, 291:1071–1080.

    Article  CAS  PubMed  Google Scholar 

  18. Paramsothy P, Morse JS, Zhao X-Q, et al.: Effect of lipid or antioxidant vitamin therapy on three year progression of electron beam tomography (EBT) coronary calcium scores [abstract]. Circulation 2008, 118:S1062.

    Google Scholar 

  19. Detrano R, Hsiai T, Wang S, et al.: Prognostic value of coronary calcification and angiographic stenosis in patients undergoing coronary angiography. J Am Coll Cardiol 1996, 27:285–290.

    Article  CAS  PubMed  Google Scholar 

  20. Schmermund A, Bailey KR, Rumberger JA, et al.: An algorithm for noninvasive identification of angiographic three-vessel and/or left main coronary artery disease in symptomatic patients on the basis of cardiac risk and electron beam computed tomographic calcium scores. J Am Coll Cardiol 1999, 33:444–452.

    Article  CAS  PubMed  Google Scholar 

  21. Virmani R, Burke AP, Kolodgie FD, et al.: Vulnerable plaque: the pathology of unstable coronary lesions. J Interv Cardiol 2002, 15:439–446.

    Article  PubMed  Google Scholar 

  22. Leber A, Knez A, White C, et al.: Composition of coronary atherosclerotic plaques in patients with acute myocardial infarction and stable angina pectoris determined by contrast-enhanced multi-slice computed tomography. Am J Cardiol 2002, 91:714–718.

    Article  Google Scholar 

  23. Shemesh J, Apter S, Itzchak Y, et al.: Coronary calcification compared in patients with acute versus in those with chronic coronary events by using dual-sector spiral CT. Radiology 2003, 226:483–488.

    Article  PubMed  Google Scholar 

  24. Sngiorgi G, Rumberger JA, Severson A, et al:. Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol 1998, 31:126–133.

    Article  Google Scholar 

  25. Schoenhagen P, Ziada KM, Kapadi SR, et al.: Extent and direction of arterial remodeling in stable versus unstable coronary syndromes: an intravascular ultrasound study. Circulation 2000, 101:598–603.

    CAS  PubMed  Google Scholar 

  26. •• Demer LL, Tintut Y: Vascular calcification: pathobiology of a multifaceted disease. Circulation 2008, 117:2398–2948. This reference is highly recommended for clinicians that see patients with coronary and other vascular calcifications. It reviews in an exhaustive fashion the processes that lead to vascular calcification. Furthermore, the mechanisms that lead to vascular calcification are compared to skeletal bone formation, a process that although parallel has some very interesting reciprocal mechanisms.

    Article  Google Scholar 

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  1. Harborview Medical Center, 325 Ninth Avenue, Box 359748, Seattle, WA, 98104, USA

    Edward A. Gill Jr.

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  1. Edward A. Gill Jr.
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Correspondence to Edward A. Gill Jr..

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Gill, E.A. Does Statin Therapy Affect the Progression of Atherosclerosis Measured by a Coronary Calcium Score?. Curr Atheroscler Rep 12, 83–87 (2010). https://doi.org/10.1007/s11883-009-0073-z

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  • DOI: https://doi.org/10.1007/s11883-009-0073-z

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