Progressive coronary calcification despite intensive lipid-lowering treatment: a randomised controlled trial

被引:143
作者
Houslay, E. S.
Cowell, S. J.
Prescott, R. J.
Reid, J.
Burton, J.
Northridge, D. B.
Boon, N. A.
Newby, D. E.
机构
[1] Univ Edinburgh, Sch Med, Edinburgh EH16 4SA, Midlothian, Scotland
[2] Royal Infirm, Dept Cardiol, Edinburgh, Midlothian, Scotland
[3] Borders Gen Hosp, Dept Radiol, Melrose, Roxburghshire, Scotland
[4] Western Gen Hosp, Dept Cardiol, Edinburgh EH4 2XU, Midlothian, Scotland
基金
英国惠康基金;
关键词
D O I
10.1136/hrt.2005.080929
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: To evaluate the effect of intensive lipid-lowering treatment on coronary artery calcification in a substudy of a trial recruiting patients with calcific aortic stenosis. Methods: In a double blind randomised controlled trial, 102 patients with calcific aortic stenosis and coronary artery calcification were randomly assigned by the minimisation technique to atorvastatin 80 mg daily or matched placebo. Coronary artery calcification was assessed annually by helical computed tomography. Results: 48 patients were randomly assigned to atorvastatin and 54 to placebo with a median follow up of 24 months (interquartile range 24-30). Baseline characteristics and coronary artery calcium scores were similar in both groups. Atorvastatin reduced serum low density lipoprotein cholesterol (253%, p < 0.001) and C reactive protein (249%, p < 0.001) concentrations whereas there was no change with placebo (27% and 17%, p > 0.95 for both). The rate of change in coronary artery calcification was 26%/year (0.234 (SE 0.037) log arbitrary units (AU)/year; n = 39) in the atorvastatin group and 18%/year (0.167 (SE 0.034) log AU/year; n = 49) in the placebo group, with a geometric mean difference of 7%/year (95% confidence interval 23% to 18%, p = 0.18). Serum low density lipoprotein concentrations were not correlated with the rate of progression of coronary calcification (r = 0.05, p = 0.62). Conclusion: In contrast to previous observational studies, this randomised controlled trial has shown that, despite reducing systemic inflammation and halving serum low density lipoprotein cholesterol concentrations, statin treatment does not have a major effect on the rate of progression of coronary artery calcification.
引用
收藏
页码:1207 / 1212
页数:6
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