Statinetherapie geen effect op coronaire calcificaties

Statin treatment reduces coronary artery stenosis but has no effect on coronary artery calcification (CAC), a meta-analysis shows.
 

"Previous observational studies of the effect of statins on CAC have given inconsistent findings," say Michael Henein (Umea University, Sweden) and Andrew Owen (Canterbury Christ Church University, UK).
 

The team's meta-analysis shows no effect on CAC, despite patients treated with high-dose statins achieving low-density lipoprotein (LDL) cholesterol reductions of about 1 mmol/l (38.7 mg/dl), relative to those given low-dose statins or placebo.

Henein and Owen identified six randomized controlled trials that examined the effect of statins on coronary stenosis and five studying their effects on CAC. The researchers standardized measurements of atheroma and CAC due to varying definitions and endpoints among the studies.
 

They report that patients taking high-dose statins achieved a significant average 0.29-point reduction in coronary artery atheroma, relative to those taking low-dose statins or placebo. The effect was consistent across all included studies.

In contrast, they experienced a nonsignificant 0.04-point increase in CAC over the 1.0-2.5-year follow-up period.
 

"Clearly, a much longer period of statin treatment may have an effect, but to date this has not been tested in a clinical trial fashion," Henein and Owen write in the International Journal of Cardiology.

The researchers say their findings confirm "previous suggestions that CAC and coronary atheroma represent different features of atherosclerotic disease with different responses to treatment, which may even have different pathophysiologies." They also caution against prescribing statins in patients with CAC but no other indications for lipid-lowering therapy.
 

"This is particularly pertinent with the increasing use of computed tomography scanning for health screening of individuals who may not have an established indication for statins," the team concludes.