| Summary: | Background: Statins are widely used for atherosclerotic plaques stabilization due to their cholesterol-lowering properties and pleotropic effects. However, the optimal drug regimens including dosage and length of treatment necessary to achieve significant improvement of ultrasound plaque morphology are still widely debated.
Methods: A total of 62 patients with carotid artery stenosis less than 60%, recruited prospectively in the current study, were divided into two groups. Patients of group 1 (n=32) were treated with 80 mg daily atorvastatin and patients of group 2 (n=30) were administered 20 mg daily atorvastatin. Plaque standardized gray scale medians (GSM) were measured in longitudinal ultrasound images to quantitate echolucency before and after 1 month treatment in all patients. Levels of cholesterol, low-density lipoproteins and C-reactive protein in serum were assessed.
Results: In group 1, a significant decrease of total cholesterol and low-density lipoproteins was observed after one month of treatment (up to 44% and 41%, respectively) while reduction in C-reactive protein levels was observed in both groups. GSM score was remarkably increased in both groups, but that augmentation was greater in group 1 (from 33.3±16.5 to 99.4±23.1) than in group 2 (from 35.9±15.6 to 76.1±21.7). No significant changes in the degree of carotid stenosis were detected in any group.
Conclusion: Aggressive high-dose lipid-lowering treatment is more effective than smaller dose one to achieve sustainable carotid plaque stabilization. Other positive effects of one month high dose statin treatment include stabilization of cholesterol levels, control of inflammatory response, and improvements in carotid arterial plaques morphology.
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