ATVB: Drug Combo May Be Best for Plaque Regression

Atorvastatin plus etidronate reduces aortic plaques more than atorvastatin alone

FRIDAY, April 29 (HealthDay News) -- The combination of atorvastatin plus etidronate appears to be superior to atorvastatin alone for causing the regression of thoracic and abdominal aortic plaques, according to research presented at the Arteriosclerosis, Thrombosis and Vascular Biology 2011 Scientific Sessions, held from April 28 to 30 in Chicago.

In a prospective, open-label, blind-end point study, Tetsuya Kawahara, M.D., of the University of Calgary in Canada, and colleagues randomized 251 patients with asymptomatic hypercholesterolemia to receive 20 mg of atorvastatin per day or 20 mg of atorvastatin plus 400 mg of etidronate per day. The primary end point was the change of atherosclerotic plaques after 24 months of treatment.

The investigators found that the mean low-density lipoprotein cholesterol level was reduced by 44 percent in the combination-therapy group and by 45 percent in the atorvastatin group (P < 0.001 versus baseline for both groups). Maximal vessel wall thickness in the thoracic aorta was reduced by 13 percent in the combination-therapy group and by 15 percent in the atorvastatin-alone group (P = 0.587). However, over 24 months, the combination-therapy group experienced higher rates of reduction of maximal vessel wall thickness in the abdominal aorta than those in the atorvastatin group (1 versus 12 percent; P < 0.001). The incidence of major cardiovascular events was lower in the combination therapy group than in the atorvastatin group (1 versus 5 percent; P = 0.049).

"This trial showed that atorvastatin plus etidronate combination therapy caused a significant regression of both thoracic and abdominal aortic plaques, whereas atorvastatin monotherapy did [so] only [for] thoracic aortic plaques. In addition, the combination therapy might be superior to atorvastatin monotherapy in decreasing the incidence of cardiovascular events," the authors write.

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