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KMID : 0928520090190030270
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Korean Journal of Lipidology
2009 Volume.19 No. 3 p.270 ~ p.273
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Regression of Atherosclerotic Plaque in Coronary Artery by Medical Therapy
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Jo Sang-ho
Kim Hyun-Sung
Kim Sung-Ae
Kim Hyun-Sook
Han Sang-jin
Choi Young-Jin
Rhim Chong-youn
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Abstract
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Courage trial demonstrated optimal medical management for stable coronary artery disease is comparable to coronary interventional therapy. Moreover, in a series of pivotal clinical trials, among medications, 3-hydroxy-3 -methylglutaryl-conenzyme A reductase inhibitors (statins) have significantly reduced the cardiovascular morbidity and mortalities. This efficacy may mainly be attributed to their property of reducing atherogenic lipoproteins and vascular inflammation, stabilizing and even regressing atherosclerotic plaque. Recent studies dealing with halting atheroma progression and reversing its progression have used high dose statins and measured primary study endpoint of atherosclerotic burden change with intravascular ultrasound which is relatively new modality. Accordingly, the clinical implications of evidence of drug benefit derived from intravascular ultrasound remain uncertain. In this skepticism we report a case of atheroma regression in patient with acute myocardial infarction with maximal medical management assessed by coronary angiogram. This definite regression of atherosclerosis gives us potential evidence that change of atheroma burden may be translated into better clinical outcome not only from plaque stabilization but also from clinical plaque regression. Moreover current report will be another rationale for supporting medical management in treating atherosclerotic disease other than interventional coronary arterial dilatation.
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