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Review
. 2022 Jul 1:11:100366.
doi: 10.1016/j.ajpc.2022.100366. eCollection 2022 Sep.

Intensive lipid lowering agents and coronary atherosclerosis: Insights from intravascular imaging

Giuseppe Di Giovanni  1   2 , Stephen J Nicholls  2
Affiliations
Review

Intensive lipid lowering agents and coronary atherosclerosis: Insights from intravascular imaging

Giuseppe Di Giovanni et al. Am J Prev Cardiol. .

Abstract

Advances in intravascular imaging have permitted comprehensive evaluation of coronary atherosclerotic plaque from the perspective of its burden and individual components. These advances have been integrated in clinical trials that have evaluated the impact of intensive lipid lowering regimens. These trials have demonstrated that intensive lipid lowering, using high dose statins as monotherapy and in combination with new lipid lowering agents, produce favorable effects on coronary atheroma, resulting in regression and stabilization. These findings provide important biological insights to understand how intensive lipid lowering may reduce cardiovascular risk. This review aims to provide the reader with a contemporary overview of the findings of these studies and to propose the potential clinical implications for management of higher risk patients with atherosclerotic coronary artery disease.

Keywords: Atherosclerosis; Clinical trials; Intravascular imaging; Lipid lowering; Risk factors.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Stephen Nicholls reports a relationship with AstraZeneca, Amgen, Anthera, CSL Behring, Cerenis, Eli Lilly, Esperion, Resverlogix, Novartis, InfraReDx and Sanofi-Regeneron that includes: funding grants. Stephen Nicholls reports a relationship with Amgen, Akcea, AstraZeneca, Boehringer Ingelheim, CSL Behring, Eli Lilly, Esperion, Kowa, Merck, Takeda, Pfizer, Sanofi-Regeneron and Novo Nordisk that includes: consulting or advisory. Stephen Nicholls has patent issued to Amgen.

Figures

Fig. 1
Fig. 1
LDL-C v plaque in IVUS trials Association between achieved levels of low-density lipoprotein cholesterol (LDL-C) and change in percent atheroma volume (PAV) in clinical trials using serial intravascular ultrasound imaging of coronary atherosclerosis. Ali, alirocumab; atorva, atorvastatin; evo, evolocumab; eze, ezetimibe; rosuva, rosuvastatin.
Fig. 2
Fig. 2
LDL-C v FCT in OCT trials Association between achieved levels of low-density lipoprotein cholesterol (LDL-C) and change in fibrous cap thickness (FCT) in clinical trials using serial optical coherence tomography imaging of coronary atherosclerosis.
Unlabelled image
See this image and copyright information in PMC

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