Crestor Reduces Plaque Build-Up in Arteries
The statin Crestor, marketed by AstraZeneca, can reverse the accumulation of plaque in the arteries, according to a study presented on Monday at a meeting of the American College of Cardiology, Reuters/New York Times reports. The finding marks the first time a statin has been shown to reverse plaque build-up (Reuters/New York Times, 3/14).
For the study, 507 participants with mild to moderate heart disease were given 40 milligrams -- the maximum dose -- of Crestor for two years. Participant's levels of LDL or "bad" cholesterol dropped from an average of about 130.4 to 60.8, a 53% reduction, the study finds.
In addition, levels of HDL or "good" cholesterol rose from an average of 43.1 to 49, an increase of about 14.7%, according to the study. Further, a comparison of arterial ultrasounds of 349 participants taken before and after treatment showed that the volume of plaque in the arteries had decreased by between 6.9% and 9.1%, the study finds (Stein, Washington Post, 3/14).
The study -- which was funded by AstraZeneca -- and an accompanying editorial have been published online in the Journal of the American Medical Association (Winslow, Wall Street Journal, 3/14). They will appear in the April 5 issue of JAMA.
Lead researcher Steven Nissen, interim chair of cardiology at the Cleveland Clinic, said he was "very surprised" by the findings, adding, "The thinking was if you got the bad cholesterol low enough you wouldn't form new plaque, but you couldn't get rid of the plaque that was already there. But we showed you could." Nissen said, "This may be the beginning of a real revolution in the treatment of heard disease. ... It's very exciting" (Washington Post, 3/14).
However, Nissen cautioned that the findings are "preliminary" and "by no means sufficient to alter" treatment guidelines (Wall Street Journal, 3/14). In addition, Nissen noted that "such high doses of Crestor" could elevate concerns about its side effects, which include potential muscle and kidney damage.
No participants in the new study experienced such side effects, he said (Gellene, Los Angeles Times, 3/14).
Robert Eckel, president of the American Heart Association, said, "We now have enough evidence to make the case for getting LDL below 70 for patients with heart disease" (Sternberg, USA Today, 3/14).
Frank Sacks of the Harvard School of Public Health said the study "is full of potential problems" because it did not use a control group. "There is no way to know really what is going on" in the absence of a control group, he said.
Elizabeth Nabel, director of the National Heart, Lung and Blood Institute, said, "This is a proof-of-principle study. It adds the next chapter in the story of lowering cholesterol" (Washington Post, 3/14).
According to the Journal, researchers decided it would be unethical to give a lower dose of the drug to patients enrolled in the study.
Sidney Wolfe, director of the Health Research Group at Public Citizen, said in a statement that Crestor should not be prescribed because of safety concerns and that other statins likely would achieve the same benefit (Wall Street Journal, 3/14).
Free full text of the study is available online.
The editorial also is available online.
Several broadcast programs reported on the Crestor study:
- ABCNews' "World News Tonight": The segment includes comments from Christopher Cannon, a physician at Brigham and Women's Hospital; Lee Green, a physician in the Department of Family Medicine at the University of Michigan; Nissen; and a study participant (Stark, "World News Tonight," ABCNews, 3/13).
- CBS' "Evening News": The segment includes comments from Nissen and a study participant (Kaledin, "Evening News," CBS, 3/13). The complete segment is available online in RealPlayer.
- NBC's "Nightly News": The segment includes comments from Nissen (Bazell, "Nightly News," NBC, 3/13). The complete segment is available online in Windows Media.
- NPR's "All Things Considered": The segment includes comments from Roger Blumenthal, director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, and Nissen (Knox, "All Things Considered," NPR, 3/13). The complete segment is available online in RealPlayer.