Findings from the ASTEROID trial showed that patients with heart disease who took the maximum dose of Rosuvastatin ( 40 mg per day; Crestor ) for 24 months and achieved on average LDL cholesterol levels below 70 mg/dL and significant increases in HDL cholesterol, had a mean reduction in the plaques that caused blockages in their arteries.
The study used two different imaging techniques to measure different segments of the coronary arteries. Both showed reduction of plaque.
ASTEROID ( A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden ) was designed to determine the effects of treatment with Rosuvastatin on progression of coronary atherosclerosis in patients who had a clinically indicated cardiac catheterization that showed angiographic evidence of coronary artery disease ( CAD ).
This study examined whether Rosuvastatin could regress coronary atherosclerosis as assessed by intravascular ultrasound ( IVUS, the primary endpoint ) and quantitative coronary angiography ( QCA, a secondary endpoint ).
As previously reported, IVUS assessment of a single coronary artery with <50 percent angiographic luminal narrowing showed atheroma volume regression.
New findings showed that the treatment also produced regression by decreasing percent diameter stenosis and improving minimum lumen diameter ( MLD ) as measured by QCA.
ASTEROID was a prospective, multicenter, open-label trial that enrolled men and women 18 years or older with a clinical indication for coronary catheterization and angiographic evidence of coronary artery disease who met specific angiographic and IVUS criteria.
Inclusion required demonstration of at least one obstruction causing more than 20 percent angiographic luminal diameter narrowing in any coronary vessel. The left main coronary artery had to have less than or equal to 50 percent reduction in lumen diameter by visual estimation, and the target vessel for IVUS interrogation could not have undergone angioplasty or bypass surgery nor have less than 50 percent luminal narrowing throughout a target segment with a minimum length of 40 mm. Segments for QCA analysis could not have undergone angioplasty or bypass surgery.
ASTEROID treated 507 coronary disease patients with Rosuvastatin 40 mg/day for 24 months. Of these patients, 379 had evaluable angiograms at baseline and at study end.
Blinded QCA analysis of percent diameter stenosis ( %DS ) and minimum lumen diameter was performed for up to 10 segments of the coronary arteries and their major branches with less than 25 percent diameter stenosis at baseline. For each patient, the means of all matched lesions at baseline and study end were calculated. There were 292 patients with 613 matched segments that met the criterion of > 25 percent stenosis.
Rosuvastatin reduced low-density lipoprotein cholesterol by 53.3 percent to 61.1 mg/dL; high-density lipoprotein cholesterol increased by 13.8 percent to 48.3 mg/dL.
Mean percent diameter stenosis decreased from 37.3 percent ( p<0.001 ).
Minimum lumen diameter increased from 1.65 mm to 1.68 mm ( p<0.001 ).
“ Previous studies have shown that statin therapy can slow the development of plaque in the coronary arteries, ” said Christie Ballantyne, at the Methodist DeBakey Heart & Vascular Center and lead author of the study. “ However, no statin monotherapy study has stopped the growth of plaque- or actually reduced the amount of plaque in the arteries in areas with narrowing or stenosis, as this study shows.”
Source: American College of Cardiology Scientific Session, 2008
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