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To the Editor: Dr Nissen and colleagues¹ reported coronary plaque regression as a result of high-dose statin therapy. In their "Comment" section, Figure 3 illustrates the relationship between achieved LDL-C levels and changes in plaque size using intravascular ultrasound, based on data from 3 randomized pharmacological intervention trials. It appears that an LDL-C value of 76 mg/dL was the cutoff at which the linear regression analysis predicted no plaque increase: the transition from progression to regression.

This is in agreement with our finding in patients with documented coronary artery disease treated by usual care who underwent serial ultrasonic examinations of the left main coronary artery during at least 12 months of follow-up.² We found that a mean LDL-C value of 75 mg/dL was the cutoff at which regression analysis predicted no plaque progression. Nissen et al have shown that further lowering of LDL-C can result in coronary plaque regression in . . . [Full Text of this Article]

Clemens von Birgelen, MD, PhD
von.birgelen@12move.nl

Marc Hartmann, MD
Department of Cardiology
Medisch Spectrum Twente
Enschede, the Netherlands

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