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To the Editor: Although Dr Nissen and colleagues¹ found a 4.2% mean reduction in atheroma, this number is actually substantially less than what has been observed in animal studies. For instance, my colleagues and I reported that a 90-minute infusion of 1 g of recombinant protein in rabbits resulted in a 30% mean reduction of plaque volume.²

I believe, however, that results of these 2 studies are comparable. Although rabbits' atheromatous lesions develop over a few months and comprise nearly 90% free cholesterol-enriched foam cells, this is not the case for human lesions. Such "removable material" (eg, foam cells and cholesterol-enriched debris) represents only 13% to 26% of the material in human plaques, depending on the age or sex of the examined individuals.^3-4 Therefore, the 4.2% reduction in human plaque volume approximates the 30% reduction we observed in rabbits. A similar approach in younger individuals with a larger volume of . . . [Full Text of this Article]

Cesare R. Sirtori, MD, PhD
cesare.sirtori@unimi.it
Department of Clinical Pharmacology
University of Milano
Milan, Italy

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