The early effect of lipid-lowering treatment on carotid and femoral intima media thickness (IMT)†

Objectives: an increased intima media thickness (IMT) is an early indicator of the atherosclerotic process. We investigated the early effect of atorvastatin on the common carotid artery (CCA) and common femoral artery (CFA) IMT. Methods: the IMT was measured in the CCA and the CFA of hyperlipidaemic patients referred with peripheral vascular disease. The measurernents were performed using an automated radio frequency IMT technique pre-treatment and at 4 and 8 weeks post-treatment with 20 mg/day atorvastatin. Results: patients (14 men; 11 women), median age 69 years (range: 48-81) had a CCA-IMT mean (SD) of 0.79 (0.21) mm pre-treatment, 0.75 (0.22) mm after 4 weeks, and 0.64 (0.15) inn after 8 weeks. The ANOVA test was significant (p = 0.024) for the CCA-IMT trend. The corresponding CFA-IMT readings were 0.83 (0.13) min, 0.80 (0.09) mm and 0.69 (0.14) min (p = 0.0003). After 8 weeks of treatment there was a significant reduction in total cholesterol 6.0 (0.3) to 4.3 (0.8) nmol/l, p = 0.0004 and low-density lipoprotein cholesterol 3.7 (0.2) to 2.2 (0.5), p = 0.0001. There was a significant decrease in median serum creatinine levels after 8 weeks treatment: 87 mumol/l (range 67-114) to 84 mumol/l (range: 64-112), p = 0.007. Conclusions: cholesterol-lowering with atorvastatin 20 mg/day leads to a decrease in CCA-IMT and CFA-IMT. This difference achieved significance after 8 weeks of treatment, belt a trend was visible at 4 weeks. These rapid changes in IMT may be attributable to an anti-inflammatory effect. IMT measurement may be a useful tool to rapidly assess the effect of drug treatment on the atherosclerotic process.