Modest regression of artery-clogging plaque found at LDL cholesterol levels below 70

The volume of artery-clogging plaque has been found to regress by up to 2% within the first year in study participants whose LDL-cholesterol level was reduced to 70 mg/dl or below, according to a study published in the Journal of the American College of Cardiology.

The study presented original research comparing the effects of a statin to the effects of a statin plus the drug ezetimibe, and described three previous studies on the effects of a statin alone.

In all four studies, when the LDL cholesterol level was brought to 70 or below, the plaque volume was reduced by 0.5% to 2% during the study period.

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The authors also cited four research trials which showed that “mean LDL cholesterol levels were closely correlated with median change” in plaque volume.

In their research study, the authors found that median LDL levels after treatment were about 8 to 15 points lower for participants on a statin plus ezetimibe, compared to those on statin alone.

A “possible mechanism underlying the clinical benefit obtained by dual lipid lowering” (with statin plus ezetimibe), said the authors, “was the suppression of the compensatory enhancement of cholesterol absorption.” They cited a study showing that “mortality increased with increasing levels of the cholesterol absorption marker, the cholestanol-to-cholesterol ratio.”

The authors said their study “found a positive correlation between the suppression of cholesterol absorption markers and coronary plaque regression.”

Evidence of a “direct relationship between the burden of coronary atherosclerosis, its progression, and adverse cardiovascular events” was found in a “large meta-analysis,” the authors added, using the medical term atherosclerosis to refer to artery clogging .

The study, available free online, is titled “Impact of Dual Lipid-Lowering Strategy With Ezetimibe and Atorvastatin on Coronary Plaque Regression in Patients With Percutaneous Coronary Intervention: The Multicenter Randomized Controlled PRECISE-IVUS Trial.”

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