JAMA Cardiology

More intensive cholesterol therapy linked to less artery plaque

Over 18 months, total coronary plaque volume fell 69.8 cubic millimeters with more intensive cholesterol-lowering therapy versus 39.0 cubic millimeters with intensive therapy.

Figure 1 from JAMA Cardiology
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Figure 1. Mortensen et al.
Randomized trial in 104 statin-naive patients with newly diagnosed stable CAD, 18 monthsInterventions

Multicenter, registered NCT04737408

Limit: Scan-based plaque was measured, but clinical outcomes and adverse events were not

Edited by Boris Djordjevic · AgingResearch.News

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A randomized trial studied 104 people with newly diagnosed stable coronary artery disease who had never taken statins. Their average age was 64, and 82 were men. Participants received either atorvastatin 40 mg or the more intensive combination of rosuvastatin 40 mg and ezetimibe 10 mg for 18 months.

Researchers used computed tomography scans to measure plaque, a buildup inside the arteries supplying the heart, at the start and after nine and 18 months. Total plaque and plaque without calcium decreased in both groups, with greater reductions in the more intensive group. Calcium-containing plaque increased similarly in both groups. Lower levels of low-density lipoprotein cholesterol, often called “bad” cholesterol, were associated with greater reductions in total plaque and plaque without calcium.

Why it matters

Coronary artery disease is an age-related illness. The authors said the findings supported the potential for partial reversal of artery plaque buildup through intensive cholesterol reduction.

Caveats

This secondary analysis assessed scan-based outcomes, which do not establish clinical benefit; the abstract does not report adverse events. The results concern people with newly diagnosed stable coronary artery disease who had not previously taken statins.