Aortic plaque regression as determined by magnetic resonance imaging with high-dose and low-dose statin therapy

Objective We sought to compare the effects of high-dose with low-dose simvastatin therapy on aortic plaque morphology using transoesophageal magnetic resonance imaging (TEMRI). Methods Thirty-one patients with established moderate-to-severe atherosclerosis were recruited and randomized to 80 versus 20 mg/day simvastatin therapy. Aortic vessel wall and lumen volumes and areas were measured by TEMRI at baseline and 12 months. Results Significant differences were observed between the low-dose and high-dose statin therapy in reduction of low-density lipoprotein cholesterol (LDL-c) (110 mg/dl, P = 0.001), total cholesterol (116.2 mg/dl, P < 0.001), vessel wall area (19.0 mm(2), P < 0.001) and volume (343.4 mm(3) P < 0.001), as well as increase in lumen area (54.4 mm(2), P < 0.001) and volume (1038 mm(3), P < 0.001). LDL-c lowering was significantly associated with aortic wall area and volume reduction in both groups. Conclusion High-dose statin leads to greater LDL-c reduction, aortic vessel wall reduction and lumen increase than low-dose statin therapy in patients with at least moderate-documented atherosclerosis.