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Statin Drug Crestor Slows Artery Plaque

Research Shows Cholesterol Drug Cuts Heart Attacks and Strokes
By
WebMD Health News
Reviewed by Louise Chang, MD

April 1, 2008 (Chicago) -- A trial of the statin drug Crestor has been halted early due to "unequivocal evidence" that it reduces heart attacks, strokes, and deaths due to cardiovascular disease in people with no signs of heart disease, says manufacturer AstraZeneca.

The details of the trial have not yet been released. But another study presented at the annual meeting of the American College of Cardiology (ACC) shows that Crestor slows the buildup of plaque that can lead to a heart attack.

This study used special X-rays of coronary arteries. Researcher Christie Ballantyne, MD, of the Center for Cardiovascular Prevention at Baylor College of Medicine in Houston, says, "We saw that if people had a blockage and we lowered their levels of LDL with Crestor, blockages stabilized or got better in 97% of patients."

The study was simultaneously published online by the journal Circulation.

"The message to patients is simple: Get your LDL cholesterol down as low as you can get," Ballantyne tells WebMD.

Statins Best for Lowering Cholesterol

Ballantyne says cholesterol lowering is best achieved with a statin drug, "particularly a potent statin like Crestor" that also boosts levels of HDL "good" cholesterol.

The prematurely stopped trial, known as JUPITER, pitted Crestor against a placebo in more than 15,000 patients with no evidence of cardiovascular disease. They had low to normal LDL levels but elevated levels of C-reactive protein, a blood marker of inflammation that's been linked to heart disease.

The announcement that it was being halted came hours after an ACC panel urged a return to statin drugs with proven clinical benefit. The panel was reacting to the disappointing news that a different type of cholesterol-lowering drug called Vytorin was no better than the older, cheaper statin drug Zocor at slowing plaque buildup. Vytorin combines the unique cholesterol drug Zetia with Zocor.

Statins with proven clinical benefit include Zocor, Pravachol, Mevacor; Lipitor, and Lescol.

"Now we have a clear indication that Crestor also prevents heart attacks and other cardiovascular events," Ballantyne says.

Plaque Buildup Slowed

Ballantyne and colleagues studied 379 patients with plaque buildup, or atherosclerosis, in the coronary arteries. The patients took a 40-milligram dose of Crestor daily for two years.

All underwent coronary angiography, X-rays of the blood vessels, at the start and the end of the study so doctors could visualize any changes in the size of blockages.

The results showed that Crestor treatment lowered LDL by 53% to an average level of 61 points, which is well below the optimal LDL target level.

Also, HDL levels shot up by 14%, to 48 points. Most importantly, angiograms showed that blockages got worse in only 3% of patients.

"If blockages get worse, you're more likely to have a clinical event such as a heart attack. So this is great news," Ballantyne says.

American Heart Association past president Raymond Gibbons, MD, of the Mayo Medical School in Rochester, Minn., says the results confirm a report last year that Crestor stops thickening of the arteries in people at low risk of heart attacks and strokes. Thickening of arterial walls is a precursor to the buildup of plaque that can lead to heart attacks and strokes.

But, Gibbons tells WebMD, the ultimate yardstick against which to measure the drug is how well it cuts the risk of heart attacks, stroke, and other cardiovascular problems. For that, we'll have to await the full results of JUPITER.

Both studies were funded by AstraZeneca.

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Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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