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Candidate Mechanisms for Regression of Coronary Atherosclerosis with High-Dose Statins

Insight from Intravascular Ultrasonography Trials

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Abstract

Animal models and serial imaging studies in humans have shown that atherosclerosis is a potentially reversible disease. Several drug classes have been tested to determine whether they can promote reversal of atherosclerosis. Of these, HMG-CoA reductase inhibitors (statins) have been consistently proven to have anti-atherosclerotic effects in large-scale clinical trials. In this article, we review the lipid- and non-lipid-based mechanisms of statin-induced disease regression using the information provided by the recent intravascular ultrasonography trials. We conclude that, despite several potential mechanisms, reduction of low-density lipoprotein cholesterol appears to be the dominant mechanism responsible for regression of atherosclerosis.

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Acknowledgments

No sources of funding were used to assist in the preparation of this review. Dr Sipahi has received educational grants and honoraria for lectures from Pfizer Inc. Dr Tuzcu has no conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Desk F25, 9500 Euclid Ave, Cleveland, Ohio, 44195, USA

    Ilke Sipahi &  E. Murat Tuzcu

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  1. Ilke Sipahi
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  2. E. Murat Tuzcu
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Correspondence to Ilke Sipahi or E. Murat Tuzcu.

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Sipahi, I., Tuzcu, E.M. Candidate Mechanisms for Regression of Coronary Atherosclerosis with High-Dose Statins. Am J Cardiovasc Drugs 8, 365–371 (2008). https://doi.org/10.2165/0129784-200808060-00003

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