© 2004 by BMJ Publishing Group & British Cardiac Society
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ISCHAEMIC HEART DISEASE
Statins are known to reduce atherogenic lipoproteins and hence cardiovascular morbidity and mortality. However, the impact of their varying efficacies on clinical outcome is unknown. Hence the REVERSAL (reversal of atherosclerosis with aggressive lipid lowering) study recruited 654 patients with low density lipoprotein (LDL) cholesterol concentrations between 3.24–5.44 mmol/l and an angiographically proven narrowing of 20% or more. Participants were randomised to 18 months of intensive treatment with atorvastatin 80 mg or moderate treatment with pravastatin 40 mg. Those in the intensive treatment group showed significantly reduced progression of coronary artery stenosis as assessed by intravascular ultrasound, with some actually showing disease regression. These differences may be due to the greater reduction in atherogenic lipoproteins and C reactive protein caused by atorvastatin.
Nissen SE, Murat Tuzcu E, Schoenhagen P, et al. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis. JAMA 2004;291:1071–80.
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