Cerivastatin induces carotid artery plaque stabilization independently of cholesterol lowering in patients with hypercholesterolaemia

To prevent cardiovascular events in hyperlipidaemic patients, plaque stabilization by inhibition of localized inflammatory reactions in the blood vessels is important in addition to cholesterol lowering. Cerivastatin, a 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor (statin), has more potent enzyme-inhibitory effects than other statins and has also been reported in vitro to inhibit, at low concentrations, various inflammatory reactions due to plaque instability. Cerivastatin was therefore administered over 12 months to five patients with hypercholesterolaemia and atherosclerotic plaque diagnosed by ultrasonography of the carotid artery, and changes in the plaque composition were determined. The mean cholesterol level decreased over the study period, although not significantly. However, the mean percentage of fibrous matrix of the plaque increased significantly from a mean of 11.2 +/- 7.7% at study entry to 18.3 +/- 5.9% at the end of the study. Additionally, the mean maximum plaque height was significantly reduced from 3.7 +/- 0.9 mm. to 3.0 +/- 0.7 mm. These results indicate that cerivastatin induces plaque stability independently of cholesterol lowering.