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Statins and Regression of Coronary Atherosclerosis
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To the Editor: Dr Nicholls and colleagues1 found that treatment with statins was associated with regression of coronary atherosclerosis (assessed by intravascular ultrasonography) when low-density lipoprotein cholesterol (LDL-C) was substantially reduced and high-density lipoprotein cholesterol (HDL-C) was increased by more than 7.5%. The authors state that it remains to be determined whether these changes translate to improved clinical outcomes because the small increases in HDL-C observed during statin therapy have never been shown to correlate with clinical outcome.
However, in a post hoc analysis of the secondary coronary heart disease prevention Greek Atorvastatin Coronary Heart Disease Evaluation (GREACE) Study, the composite end point of all vascular events was found to be partly determined by the extent of atorvastatin-induced HDL-C increase in the structured care group compared with usual care.2 This was in the setting of achieving an LDL-C level of 100 mg/dL (2.59 mmol/L) in 95% of patients in the . . . [Full Text of this Article]
Vasilios G. Athyros, MD
athyros@med.auth.gr
Anna Kakafika, MD;
Asterios Karagiannis, MD
Aristotelian University
Thessaloniki, Greece
Dimitri P. Mikhailidis, MD, FFPM, FRCP, FRCPath
Royal Free University College Medical School
London, England
RELATED LETTER
Statins and Regression of Coronary Atherosclerosis—Reply
Stephen J. Nicholls, E. Murat Tuzcu, and Steven E. Nissen
JAMA. 2007;297(20):2197.
EXTRACT
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RELATED ARTICLE
Statins, High-Density Lipoprotein Cholesterol, and Regression of Coronary Atherosclerosis
Stephen J. Nicholls, E. Murat Tuzcu, Ilke Sipahi, Adam W. Grasso, Paul Schoenhagen, Tingfei Hu, Kathy Wolski, Tim Crowe, Milind Y. Desai, Stanley L. Hazen, Samir R. Kapadia, and Steven E. Nissen
JAMA. 2007;297(5):499-508.
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