Roundtable discussion
The Editor’s Roundtable: Atherosclerosis Regression

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Acknowledgment

This CME activity is sponsored by an educational grant from AstraZeneca, Wilmington, Delaware.

Disclosure

Dr. Friedewald receives honoraria for speaking for Novartis, East Hanover, New Jersey; and GlaxoSmithKline, Research Triangle Park, North Carolina. Dr. Ballantyne receives grant and research support from Abbott Laboratories, Abbott Park, Illinois; ActivBiotics, Lexington, Massachusetts; Gene Logic, Gaithersburg, Maryland; GlaxoSmithKline; Integrated Therapeutics, Kenilworth, New Jersey; Merck, Whitehouse Station, New Jersey; Pfizer, New York, New York; Schering-Plough, Kenilworth, New Jersey;

Objectives

Upon completion of the activity, the physician should be able to:

  • 1

    Define “atherosclerosis regression.”

  • 2

    Describe the reversible components of atherosclerotic plaque.

  • 3

    Explain the role of intravascular ultrasound (IVUS) in atherosclerosis studies.

  • 4

    Discuss with individual patients the relation between low-density lipoprotein target levels and atherosclerosis regression in order to improve patient compliance.

Discussion

Dr. Friedewald: How is atherosclerosis regression measured?

Dr. Nissen: Intravascular ultrasound (IVUS) is the most reliable measure of atherosclerosis regression and progression. Regression is defined as a negative change of some measure of atherosclerosis, or <0, with 95% confidence limits that do not include 0. Using that standard, prior to ASTEROID (A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound–Derived Coronary Atheroma Burden),2 regression with a low-density

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References (9)

  • L.W. Klein

    Atherosclerosis regression, vascular remodeling, and plaque stabilization

    J Am Coll Cardiol

    (2007)
  • S.E. Nissen et al.

    Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial

    JAMA

    (2004)
  • S.E. Nissen et al.

    Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial

    JAMA

    (2006)
  • S.J. Nicholls et al.

    Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis

    JAMA

    (2007)
There are more references available in the full text version of this article.

This discussion took place at Baylor University Medical Center, Dallas, Texas, on August 29, 2006, and September 30, 2007.

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