Interv Akut Kardiol. 2016;15(4):179-182 | DOI: 10.36290/kar.2016.035

Coronary atherosclerosis regression - theory, facts and clinical relevance

Jan F.Vojáček

¹ . interní kardioangiologická klinika LF UK a FN Hradec Králové

Subendothelial accumulation of apo-lipoprotein B with high content of lipoproteins in the predisposed sections of the artery with diffuse

intimal thickening is the main mechanism of the development of coronary atherosclerosis. A local biological response to these stored

and subsequently modified lipoproteins is a chronic inflammation mediated primarily by macrophages and T cells. Lipid lowering by

high intensity statin treatment leads to the stabilization of coronary plaques and reduction of the occurrences of clinical episodes of

destabilisation of coronary disease. Using the newer high precision imaging techniques such as intracoronary ultrasound, virtual histology,

optical coherence tomography and NMR showed that the reduction of LDL-cholesterol using high intensity statin therapy leads to

demonstrable regression of coronary plaques. Just completed GLAGOV study demonstrated the possibility of further lowering of LDL

cholesterol by combination therapy of high intensity statins with PCSK9 inhibitor evolocumab. Further decline in LDL levels as compared

to previous studies was observed with corresponding regression of the plaque volume as demonstrated by intracoronary ultrasound.

Keywords: atherosclerosis, coronary plaque, progression/ regression, statins, PCSK9 inhibitors

Published: December 1, 2016  Show citation