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(Circulation. 2002;106:e9041.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The Lower the LDL, the Better

A small study involving 161 patients found that lowering LDL to <100 mg/dL actually caused regression of carotid intima-media thickness, a surrogate measure for atherosclerosis. The study from the Walter Reed Army Medical Center in Washington, DC, appears in this week’s issue of Circulation (2002;106:2055–2060).

In this single-center randomized study led by Allen J. Taylor, MD, Director of the Cardiovascular Research Cardiology Service at Walter Reed, patients were randomly assigned to treatment with either pravastatin (40 mg/d) or atorvastatin (80 mg/d). Blinded, serial assessment of the far wall of the distal common carotid artery was made over a 12-month period.

During the year, atorvastatin was more potent in reducing LDL. Patients in the atorvastatin group averaged 76 mg/dL, a reduction of 48.5% in LDL compared with 110 mg/dL (27.2% reduction) in the pravastatin group. During the same year, members of the atorvastatin group saw their carotid intima-media thickness reduced by 0.034 mm, whereas the change in the measurement was not statistically significant in the pravastatin group.

The authors concluded that reducing LDL markedly below 100 mg/dL with atorvastatin was superior to treatment with pravastatin in achieving this surrogate for atherosclerosis regression. They concluded that such lowering "supports the hypothesis currently being tested in ongoing randomized clinical trials that marked LDL reduction with synthetic statins may provide enhanced reduction in clinical coronary event rates."

In an accompanying editorial (Circulation. 2002; 106:2039–2040), Prediman K. Shah, MD, from the Division of Cardiology and Atherosclerosis Research Center, Burns and Allen Research Institute, . . . [Full Text of this Article]