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Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study
. Background. In several statin trials, vascular event rates for treatment groups begin to separate 1 year after commencement of treatment. For atherosclerosis progression, the temporal sequence of the effect has not been defined. We used data from the Measuring Effects on intima media Thickness: a...
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| Published in: | Journal of internal medicine 2009-06, Vol.265 (6), p.698-707 |
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| creator | Bots, M. L. Palmer, M. K. Dogan, S. Plantinga, Y. Raichlen, J. S. Evans, G. W. O’Leary, D. H. Grobbee, D. E. Crouse III, J. R. |
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Background. In several statin trials, vascular event rates for treatment groups begin to separate 1 year after commencement of treatment. For atherosclerosis progression, the temporal sequence of the effect has not been defined. We used data from the Measuring Effects on intima media Thickness: an Evaluation Of Rosuvastatin (METEOR) trial to determine the earliest time point at which significant differences in atherosclerosis progression rates could be detected after initiation of statin therapy.
Methods. The METEOR trial was a double‐blind, randomized placebo‐controlled trial that studied the effect of LDL‐C lowering with 40 mg rosuvastatin on the rate of change of carotid intima media thickness (CIMT) measured by B‐mode ultrasound amongst 984 low risk subjects. Ultrasound assessments were made at baseline and every 6 months up to 2 years.
Results. Rosuvastatin treatment was associated with a 49% reduction in LDL‐C‐C, a 34% reduction in total cholesterol, an 8.0% increase in HDL‐C and a 16% reduction in triglycerides (all P |
| doi_str_mv | 10.1111/j.1365-2796.2009.02073.x |
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Background. In several statin trials, vascular event rates for treatment groups begin to separate 1 year after commencement of treatment. For atherosclerosis progression, the temporal sequence of the effect has not been defined. We used data from the Measuring Effects on intima media Thickness: an Evaluation Of Rosuvastatin (METEOR) trial to determine the earliest time point at which significant differences in atherosclerosis progression rates could be detected after initiation of statin therapy.
Methods. The METEOR trial was a double‐blind, randomized placebo‐controlled trial that studied the effect of LDL‐C lowering with 40 mg rosuvastatin on the rate of change of carotid intima media thickness (CIMT) measured by B‐mode ultrasound amongst 984 low risk subjects. Ultrasound assessments were made at baseline and every 6 months up to 2 years.
Results. Rosuvastatin treatment was associated with a 49% reduction in LDL‐C‐C, a 34% reduction in total cholesterol, an 8.0% increase in HDL‐C and a 16% reduction in triglycerides (all P < 0.0001 compared with placebo). The difference in rate of mean maximum CIMT progression between the rosuvastatin and placebo groups (based on near and far wall measurements from both left and right common carotid and internal carotid segments and carotid bifurcation) was not statistically significant after 6 months (0.0023 mm year−1 and 0.0106 mm year−1, respectively P = 0.34). After 12 months, CIMT progression rates were significantly different between the groups: 0.0032 mm year−1 and 0.0133 mm year−1 in the rosuvastatin‐treated and placebo‐treated groups, respectively (P = 0.049). This divergence grew with further follow‐up: −0.0009 mm year−1 and 0.0131 mm year−1 after 18 months (P < 0.001) and −0.0014 mm year−1 and 0.0131 mm year−1 after 24 months of treatment (P < 0.001). Results were stronger for the mean common CIMT progression (based on near and far wall measurements from both left and right common carotid segments).
Conclusion. Aggressive LDL‐C lowering seems to exert its beneficial effect on atherosclerosis progression during the first 12 months of treatment. This parallels the timing of event reduction seen in clinical trials and suggests that the efficacy of lipid lowering treatment on CIMT progression can be evaluated in trials with a duration of 1 year, given sufficient sample size, high precision of measurements and a treatment effect comparable to that seen in METEOR.
Trial Registration: Clinicaltrials.gov identifier: NCT00225589.</description><identifier>ISSN: 0954-6820</identifier><identifier>EISSN: 1365-2796</identifier><identifier>DOI: 10.1111/j.1365-2796.2009.02073.x</identifier><identifier>PMID: 19298496</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Aged ; Anticholesteremic Agents - therapeutic use ; atherosclerosis ; Atherosclerosis (general aspects, experimental research) ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Carotid Artery Diseases - diagnostic imaging ; Carotid Artery Diseases - drug therapy ; Cholesterol, LDL - blood ; Disease Progression ; Double-Blind Method ; Female ; Fluorobenzenes - therapeutic use ; General aspects ; Humans ; Hypercholesterolemia - prevention & control ; Male ; Medical sciences ; Middle Aged ; prevention ; Pyrimidines - therapeutic use ; Rosuvastatin Calcium ; statin ; Sulfonamides - therapeutic use ; Time Factors ; Treatment Outcome ; trial ; Tunica Intima - diagnostic imaging ; Tunica Intima - drug effects ; Ultrasonography ; ultrasound ; vascular disease</subject><ispartof>Journal of internal medicine, 2009-06, Vol.265 (6), p.698-707</ispartof><rights>2009 Blackwell Publishing Ltd</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4483-b6a648389bc55c0435230f8249188a7a85cf08374c1e70ac119b6c22e1b1819a3</citedby><cites>FETCH-LOGICAL-c4483-b6a648389bc55c0435230f8249188a7a85cf08374c1e70ac119b6c22e1b1819a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2796.2009.02073.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2796.2009.02073.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21431828$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19298496$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bots, M. L.</creatorcontrib><creatorcontrib>Palmer, M. K.</creatorcontrib><creatorcontrib>Dogan, S.</creatorcontrib><creatorcontrib>Plantinga, Y.</creatorcontrib><creatorcontrib>Raichlen, J. S.</creatorcontrib><creatorcontrib>Evans, G. W.</creatorcontrib><creatorcontrib>O’Leary, D. H.</creatorcontrib><creatorcontrib>Grobbee, D. E.</creatorcontrib><creatorcontrib>Crouse III, J. R.</creatorcontrib><creatorcontrib>METEOR Study Group</creatorcontrib><title>Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study</title><title>Journal of internal medicine</title><addtitle>J Intern Med</addtitle><description>.
Background. In several statin trials, vascular event rates for treatment groups begin to separate 1 year after commencement of treatment. For atherosclerosis progression, the temporal sequence of the effect has not been defined. We used data from the Measuring Effects on intima media Thickness: an Evaluation Of Rosuvastatin (METEOR) trial to determine the earliest time point at which significant differences in atherosclerosis progression rates could be detected after initiation of statin therapy.
Methods. The METEOR trial was a double‐blind, randomized placebo‐controlled trial that studied the effect of LDL‐C lowering with 40 mg rosuvastatin on the rate of change of carotid intima media thickness (CIMT) measured by B‐mode ultrasound amongst 984 low risk subjects. Ultrasound assessments were made at baseline and every 6 months up to 2 years.
Results. Rosuvastatin treatment was associated with a 49% reduction in LDL‐C‐C, a 34% reduction in total cholesterol, an 8.0% increase in HDL‐C and a 16% reduction in triglycerides (all P < 0.0001 compared with placebo). The difference in rate of mean maximum CIMT progression between the rosuvastatin and placebo groups (based on near and far wall measurements from both left and right common carotid and internal carotid segments and carotid bifurcation) was not statistically significant after 6 months (0.0023 mm year−1 and 0.0106 mm year−1, respectively P = 0.34). After 12 months, CIMT progression rates were significantly different between the groups: 0.0032 mm year−1 and 0.0133 mm year−1 in the rosuvastatin‐treated and placebo‐treated groups, respectively (P = 0.049). This divergence grew with further follow‐up: −0.0009 mm year−1 and 0.0131 mm year−1 after 18 months (P < 0.001) and −0.0014 mm year−1 and 0.0131 mm year−1 after 24 months of treatment (P < 0.001). Results were stronger for the mean common CIMT progression (based on near and far wall measurements from both left and right common carotid segments).
Conclusion. Aggressive LDL‐C lowering seems to exert its beneficial effect on atherosclerosis progression during the first 12 months of treatment. This parallels the timing of event reduction seen in clinical trials and suggests that the efficacy of lipid lowering treatment on CIMT progression can be evaluated in trials with a duration of 1 year, given sufficient sample size, high precision of measurements and a treatment effect comparable to that seen in METEOR.
Trial Registration: Clinicaltrials.gov identifier: NCT00225589.</description><subject>Aged</subject><subject>Anticholesteremic Agents - therapeutic use</subject><subject>atherosclerosis</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Carotid Artery Diseases - diagnostic imaging</subject><subject>Carotid Artery Diseases - drug therapy</subject><subject>Cholesterol, LDL - blood</subject><subject>Disease Progression</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Fluorobenzenes - therapeutic use</subject><subject>General aspects</subject><subject>Humans</subject><subject>Hypercholesterolemia - prevention & control</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>prevention</subject><subject>Pyrimidines - therapeutic use</subject><subject>Rosuvastatin Calcium</subject><subject>statin</subject><subject>Sulfonamides - therapeutic use</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>trial</subject><subject>Tunica Intima - diagnostic imaging</subject><subject>Tunica Intima - drug effects</subject><subject>Ultrasonography</subject><subject>ultrasound</subject><subject>vascular disease</subject><issn>0954-6820</issn><issn>1365-2796</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNqNkMuO0zAUQC0EYsrALyBvYJfgR-LYLJDQqEDRjCqhYW057s3UVeIU26FTiQUSf8qX4NBq2OKFryWf-zoIYUpKms-bXUm5qAvWKFEyQlRJGGl4ef8ILR4-HqMFUXVVCMnIBXoW444QyokgT9EFVUzJSokF-rHyCXx03wH3bu82uB8PEJy_w4M54gCbyQLeh_EuQIxu9HjssDVhTBk1aQthjLafbxfxwaWt85iy3z9_DaNP2zjTKYBJA_j0Fmce3yxvl-svOKZpc3yOnnSmj_DiHC_R1w_L26tPxfX64-rq_XVhq0ryohVG5ChVa-vakorXjJNOskpRKU1jZG07InlTWQoNMZZS1QrLGNCWSqoMv0SvT3XzIt8miEkPLlroe-NhnKIWDWe5lMygPIE2bxQDdHof3GDCUVOiZ_N6p2fBehasZ_P6r3l9n1NfnntM7QCbf4ln1Rl4dQZMtKbvgvHWxQeO0YpTyeYZ3p24g-vh-N8D6M_r1c385H8A8GKg5Q</recordid><startdate>200906</startdate><enddate>200906</enddate><creator>Bots, M. L.</creator><creator>Palmer, M. K.</creator><creator>Dogan, S.</creator><creator>Plantinga, Y.</creator><creator>Raichlen, J. S.</creator><creator>Evans, G. W.</creator><creator>O’Leary, D. H.</creator><creator>Grobbee, D. E.</creator><creator>Crouse III, J. R.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200906</creationdate><title>Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study</title><author>Bots, M. L. ; Palmer, M. K. ; Dogan, S. ; Plantinga, Y. ; Raichlen, J. S. ; Evans, G. W. ; O’Leary, D. H. ; Grobbee, D. E. ; Crouse III, J. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4483-b6a648389bc55c0435230f8249188a7a85cf08374c1e70ac119b6c22e1b1819a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Anticholesteremic Agents - therapeutic use</topic><topic>atherosclerosis</topic><topic>Atherosclerosis (general aspects, experimental research)</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Carotid Artery Diseases - diagnostic imaging</topic><topic>Carotid Artery Diseases - drug therapy</topic><topic>Cholesterol, LDL - blood</topic><topic>Disease Progression</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Fluorobenzenes - therapeutic use</topic><topic>General aspects</topic><topic>Humans</topic><topic>Hypercholesterolemia - prevention & control</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>prevention</topic><topic>Pyrimidines - therapeutic use</topic><topic>Rosuvastatin Calcium</topic><topic>statin</topic><topic>Sulfonamides - therapeutic use</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>trial</topic><topic>Tunica Intima - diagnostic imaging</topic><topic>Tunica Intima - drug effects</topic><topic>Ultrasonography</topic><topic>ultrasound</topic><topic>vascular disease</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bots, M. L.</creatorcontrib><creatorcontrib>Palmer, M. K.</creatorcontrib><creatorcontrib>Dogan, S.</creatorcontrib><creatorcontrib>Plantinga, Y.</creatorcontrib><creatorcontrib>Raichlen, J. S.</creatorcontrib><creatorcontrib>Evans, G. W.</creatorcontrib><creatorcontrib>O’Leary, D. H.</creatorcontrib><creatorcontrib>Grobbee, D. E.</creatorcontrib><creatorcontrib>Crouse III, J. R.</creatorcontrib><creatorcontrib>METEOR Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bots, M. L.</au><au>Palmer, M. K.</au><au>Dogan, S.</au><au>Plantinga, Y.</au><au>Raichlen, J. S.</au><au>Evans, G. W.</au><au>O’Leary, D. H.</au><au>Grobbee, D. E.</au><au>Crouse III, J. R.</au><aucorp>METEOR Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study</atitle><jtitle>Journal of internal medicine</jtitle><addtitle>J Intern Med</addtitle><date>2009-06</date><risdate>2009</risdate><volume>265</volume><issue>6</issue><spage>698</spage><epage>707</epage><pages>698-707</pages><issn>0954-6820</issn><eissn>1365-2796</eissn><notes>The METEOR study group listed in the appendix</notes><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-News-1</notes><notes>ObjectType-Feature-3</notes><notes>content type line 23</notes><abstract>.
Background. In several statin trials, vascular event rates for treatment groups begin to separate 1 year after commencement of treatment. For atherosclerosis progression, the temporal sequence of the effect has not been defined. We used data from the Measuring Effects on intima media Thickness: an Evaluation Of Rosuvastatin (METEOR) trial to determine the earliest time point at which significant differences in atherosclerosis progression rates could be detected after initiation of statin therapy.
Methods. The METEOR trial was a double‐blind, randomized placebo‐controlled trial that studied the effect of LDL‐C lowering with 40 mg rosuvastatin on the rate of change of carotid intima media thickness (CIMT) measured by B‐mode ultrasound amongst 984 low risk subjects. Ultrasound assessments were made at baseline and every 6 months up to 2 years.
Results. Rosuvastatin treatment was associated with a 49% reduction in LDL‐C‐C, a 34% reduction in total cholesterol, an 8.0% increase in HDL‐C and a 16% reduction in triglycerides (all P < 0.0001 compared with placebo). The difference in rate of mean maximum CIMT progression between the rosuvastatin and placebo groups (based on near and far wall measurements from both left and right common carotid and internal carotid segments and carotid bifurcation) was not statistically significant after 6 months (0.0023 mm year−1 and 0.0106 mm year−1, respectively P = 0.34). After 12 months, CIMT progression rates were significantly different between the groups: 0.0032 mm year−1 and 0.0133 mm year−1 in the rosuvastatin‐treated and placebo‐treated groups, respectively (P = 0.049). This divergence grew with further follow‐up: −0.0009 mm year−1 and 0.0131 mm year−1 after 18 months (P < 0.001) and −0.0014 mm year−1 and 0.0131 mm year−1 after 24 months of treatment (P < 0.001). Results were stronger for the mean common CIMT progression (based on near and far wall measurements from both left and right common carotid segments).
Conclusion. Aggressive LDL‐C lowering seems to exert its beneficial effect on atherosclerosis progression during the first 12 months of treatment. This parallels the timing of event reduction seen in clinical trials and suggests that the efficacy of lipid lowering treatment on CIMT progression can be evaluated in trials with a duration of 1 year, given sufficient sample size, high precision of measurements and a treatment effect comparable to that seen in METEOR.
Trial Registration: Clinicaltrials.gov identifier: NCT00225589.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19298496</pmid><doi>10.1111/j.1365-2796.2009.02073.x</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anticholesteremic Agents - therapeutic use atherosclerosis Atherosclerosis (general aspects, experimental research) Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Carotid Artery Diseases - diagnostic imaging Carotid Artery Diseases - drug therapy Cholesterol, LDL - blood Disease Progression Double-Blind Method Female Fluorobenzenes - therapeutic use General aspects Humans Hypercholesterolemia - prevention & control Male Medical sciences Middle Aged prevention Pyrimidines - therapeutic use Rosuvastatin Calcium statin Sulfonamides - therapeutic use Time Factors Treatment Outcome trial Tunica Intima - diagnostic imaging Tunica Intima - drug effects Ultrasonography ultrasound vascular disease |
| title | Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study |
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