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To the Editor: We have 2 concerns about the study by Dr Nissen and colleagues.¹ First, we were puzzled by why the authors did not compare 2 dosages of the same statin. Not only would this design have been in accordance with the ongoing Treating to New Targets study, it also could supply pathophysiological data for the possible differences in the primary end point in that study.² We are concerned that the results may be oversimplified by suggesting superiority of atorvastatin over pravastatin. Had the authors used the same drug in both groups, attention could have been focused toward intensive vs moderate lipid lowering.

Second, we are concerned that the ultrasound images may be misinterpreted. For instance, in their figure 3, Nissen et al provided an intravascular image showing a substantial reduction of 43% in atheroma area. Such a result, in fact, was atypical for the entire group of patients . . . [Full Text of this Article]

Pim van der Harst, MD
p.van.der.harst@thorax.azg.nl

Wiek H. van Gilst, PhD; Felix Zijlstra, MD, PhD
University Hospital Groningen
Groningen, the Netherlands