A new study shows that a cholesterol-fighting drug is the first to reverse heart disease. The compound, called Crestor, actually caused a reduction in the amount of fatty plaques clogging the arteries of heart patients.
Crestor is among a class of anti-cholesterol treatments called statins that fight buildup of fatty plaques in arteries, a condition called atherosclerosis. Previously, the best a statin could do was stop the buildup. Physician Steven Nissen of the Cleveland Clinic in Ohio says he thought that was all Crestor would do in his two-year study of more than 500 patients with high cholesterol levels and heart disease.
"I received the data about 3.5 weeks ago, not, frankly, expecting to see any different results than we had seen in the prior trials, namely no progression, but no regression either," said Steven Nissen.
But when the data were tallied, Nissen found that the maximum daily dose of Crestor, 40 milligrams, did indeed reverse artery plaque buildup in two-thirds of the study patients.
"The amount of regression was surprisingly large," he said. "It was anywhere between seven and nine percent of volume in the artery. What happened was highly statistically significant."
Crestor also reduced the amount of the bad LDL cholesterol circulating in the blood of the patients by more than 53 percent, the lowest levels ever seen in a study. And it raised the amount of the good HDL cholesterol by almost 15 percent.
"We concluded, therefore, that if you lowered LDL cholesterol to these very low levels and kept it there for two years, particularly accompanied by the increase in HDL cholesterol, you could partially reduce coronary disease," continued Steven Nissen. "You could remove plaque from the coronary arteries in fairly sizable quantities."
Heart attacks occur when plaque eventually increases enough to block circulation in an artery carrying blood to or from the heart. Some strokes occur when a piece of plaque breaks away and lodges in a brain blood vessel. Nissen told a meeting of heart doctors in Atlanta that the study did not prove that lowering plaque volume in arteries actually leads to fewer such events, but he says he believes that benefit inevitably follows.
The research appears in the Journal of the American Medical Association, where an editorial calls it pioneering work that revolutionizes the understanding of how atherosclerosis responds to drugs. One of the editorial's authors is physician Roger Blumenthal of the Johns Hopkins University in Baltimore, who also addressed the heart doctors' meeting.
"While there will still be skeptics out there and there may be some skeptics in this room still, I think the data do show regression, reversal, and it's a very exciting finding scientifically," said Roger Blumenthal.
Crestor is manufactured by the drug company AstraZeneca, whose stock price rose 2.3 percent upon news of the study results. The company has been countering consumer groups that want to remove the compound from the market. The critics argue that it causes more negative side effects than its competitors, including muscle problems and kidney damage. U.S. government drug regulators have not removed it from the market, but have required a warning about the potential side effects on its label.
Dr. Nissen says his study showed no worse kidney damage than other statin drugs, adding that he believes the drug has no safety disadvantages outweighing its benefit.
