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Coronary artery disease: Rosuvastatin may reverse atherosclerosis

A two-year study demonstrated that Rosuvastatin ( Crestor ) reversed plaque build-up in the arteries of patients with evidence of coronary artery disease.

This is the first time a statin has demonstrated regression of atherosclerosis in a major clinical study.
Data showed that plaque build-up in patients’arteries was reduced by between seven and nine per cent.
These significant changes were achieved with Rosuvastatin and were associated with significant reductions in LDL cholesterol ( LDL-C ) ( 53 per cent, p<0.001 ) and increases in HDL cholesterol ( HDL-C )( 15 per cent, p<0.001 ).

ASTEROID ( A Study To Evaluate the Effect of Rosuvastatin On Intravascular Ultrasound-Derived Coronary Atheroma Burden ) was a 104-week, open label, single-arm, blinded endpoint study designed to study the effect of Rosuvastatin 40mg in 507 patients who had undergone coronary angiography and who had evidence of coronary artery disease ( CAD ).

The plaque volume in the target coronary artery was measured at the initial catheterisation and again after two years of treatment.
ASTEROID used intravascular ultrasound ( IVUS ) imaging to measure the effect on the change in plaque volume compared to baseline in the target vessel.

Key findings of the study in the 349 patients with evaluable IVUS data include:

- Rosuvastatin brought about a 0.79% ( median ) reduction in percent atheroma volume in the entire target vessel ( p<0.001 ) – first primary endpoint;

- Rosuvastatin brought about a 9.1% ( median ) reduction in total atheroma volume in the most diseased 10mm segment of the target vessel ( p<0.001 ) – second primary endpoint;

- Rosuvastatin brought about a 6.8% ( median ) reduction in total atheroma volume in the entire target vessel ( p<0.001 ) – secondary endpoint;

- These changes were associated with a 53% reduction in LDL-C ( p<0.001 ) and a 15% increase in HDL-C ( p<0.001 );

- Significant regression occurred in all patient subgroups including men and women, and older and younger patients;

- Rosuvastatin 40 mg was well tolerated in the two-year study.

The authors concluded that “ very high-intensity statin therapy using Rosuvastatin 40 mg/d achieved an average LDL-C of 60.8 mg/dL and increased HDL-C by 14.7%, resulting in significant regression of atherosclerosis for all 3 prespecified IVUS measures of disease burden. Treatment to LDL-C levels below currently accepted guidelines, when accompanied by significant HDL-C increases, can regress atherosclerosis in coronary disease patients. Further studies are needed to determine the effect of the observed changes on clinical outcome.”

Source: Journal of American Medical Association, 2006