Coronary calcification progression unrelated to long-term cholesterol reduction
MedWire News: Changes in serum cholesterol levels achieved with long-term use of lipid-lowering therapy do not noticeably alter the rate at which coronary artery calcification progresses, study results show.
The findings arise from an analysis of the computed tomography (CT) scans of 510 stable angina patients with a mean age of 63 years, which is published in the International Journal of Cardiology.
All patients were randomly allocated to receive lipid-lowering therapy, defined as a statin and/or fibrate (LLT; n=372) or no lipid-lowering therapy (LLT-free; n=138), and underwent CT scanning every 2 years.
Alexander Tenenbaum (Tel-Aviv University, Israel) and co-investigators report that after a median follow-up period of almost 6 years, a greater reduction in serum cholesterol was observed among LLT patients compared with LLT-free patients. Indeed, over the follow-up period, mean serum cholesterol fell by 32 mg/dl (0.83 mmol/l) in the LLT group and by 22 mg/dl (0.57 mmol/l) in the LLT-free group.
However, over the same period, a similar increase in total coronary calcium score (TCS) was seen among patients in both groups, with respective score increases of 437 and 383 among the LLT and LLT-free groups.
TCS showed no correlation with total cholesterol at baseline, and TCS changes did not correlate with total cholesterol changes over the study period.
When the researchers assessed the development of new calcified lesions in 467 patients of the original cohort, they found that a similar number of LLT and LLT-free patients developed new lesions, at rates of 27.3% and 31.5%, respectively.
TCS changes over the study period were found to be independently predicted by baseline TCS, patient age, and body mass index on multivariate analysis.
Tenenbaum and team conclude: "These data are in line with some previous short-term studies, which have shown that longitudinal cholesterol changes and LLT does not influence progression of coronary calcium."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Lauretta Ihonor