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

Scottish Aortic Stenosis and Lipid Lowering Therapy, Impact on Regression trial Investigators, E S Houslay, S J Cowell, R J Prescott, J Reid, J Burton, D B Northridge, N A Boon, D E Newby

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

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 (−53%, p < 0.001) and C reactive protein (−49%, p < 0.001) concentrations whereas there was no change with placebo (−7% 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 −3% 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.
Original languageEnglish
Pages (from-to)1207-12
Number of pages6
JournalHeart
Volume92
Issue number9
DOIs
Publication statusPublished - Sept 2006

Keywords / Materials (for Non-textual outputs)

  • Adult
  • Aged
  • Aortic Valve Stenosis
  • Calcinosis
  • Coronary Artery Disease
  • Disease Progression
  • Double-Blind Method
  • Female
  • Heptanoic Acids
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Male
  • Middle Aged
  • Pyrroles
  • Tomography, Spiral Computed
  • Treatment Failure

Fingerprint

Dive into the research topics of 'Progressive coronary calcification despite intensive lipid-lowering treatment: a randomised controlled trial'. Together they form a unique fingerprint.

Cite this