Pravastatin Plays Significant Role in Preventing Progression of Coronary Atherosclerosis

Clinical efficacy of pravastatin might be better determined by the percent decrease in total cholesterol levels than by the absolute cholesterol level, say Japanese researchers.

A team from the department of cardiology at Tokyo’s Juntendo University School of Medicine investigated the relationship between decreased serum lipid levels during the therapy with pravastatin and changes in coronary angiography parameters among 265 patients with coronary atherosclerosis.

The predominantly male participants aged between 18 and 75 years were noted to have 25% stenosis of one or more coronary arteries and a serum total cholesterol (TC) level of 200 mg/dL or greater (5.18 mM/I) and continued treatment with pravastatin for 3 years.

Coronary angiography was performed before and 3 years after commencing the statin therapy to assess the relationship between mean segment diameter (MSD), minimal lumen diameter (MLD) and yearly changes in percent stenosis and TC levels.

Subsequently 129 of the initial participant patients were followed for an average of 35 months. Only 68 patients underwent second angiograms, therefore this group was used for analysis.

Researchers noted that during pravastatin therapy, the TC level decreased significantly from 239 mg/dL (6.19mM/l) to 210 mg/dL (5.44 mM/l), a 12% reduction (P<0.001). There was also a 5% increase in HDL-cholesterol although there was no significant change in triglyceride level (P=0.007). During follow-up, researchers noted a significant improvement in both MSD and MLD, which increased from 2.67mm to 2.76 mm and from 2.09 mm to 2.13 mm respectively, although they did not observe any changes in percent stenosis. There was also no correlation during treatment in the mean TC level and changes of angiography parameters, but a significant correlation was seen between the percent reduction of TC and the annual changes of MSD (R=-0.272, P=0.027). Furthermore a similar relationship was noted between the changes of MLD and percent reduction of TC (R=-0.260, P=0.035). Journal of Atheroscler Thrombosis 2003;10:1:25-31.