The ASTEROID trial – the influence of rosuvastatin therapy on atheroma burden in coronary arteries – assessement by the use of intravascular ultrasonography Review article

Abstract

ASTEROID (A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Atheroma Burden) was a prospective, end-points multicenter trial which assessed the effects of rosuvastatin on atherosclerosis regression in patients with coronary artery disease (CAD). 349 patients with CAD received 40 mg/day of rosuvastatin for 24 months. In order to measure atheroma burden each patient went through intravascular ultrasound examination (IVUS) at baseline and following 24 months of therapy. Two primary efficacy parameters were prespecified: the change in percentage atheroma volume (PAV) and the change in total atheroma volume (TAV) in the 10-mm subsegment with the greatest disease severity at baseline. Rosuvastatin therapy lowered low-density lipoprotein cholesterol from 130,4 to 60,8 mg/dl and raised high-density lipoprotein cholesterol from 43,1 do 49 mg/dl. This was associated with a significant reduction in IVUS measures of atheroma burden. The mean change in PAV was -0,98% (p <0,001 vs baseline). The mean change in TAV in the most diseased 10-mm subsegment was -6,1 mm3 (p <0,001 vs baseline). In contrast to prior studies in which statins have been shown to decrease/stop atherosclerosis progression, the ASTEROID trial was the first to show evidence that intensive modification of lipid levels with high-dose statin therapy can promote atheroma regression.