Atorvastatin plus etidronate combination therapy reduces atherosclerotic aortic plaques

A bisphosphonate plus statin resulted in a significant regression in the build-up of plaques in the aorta, compared with use of the cholesterol drug alone, in a carefully done but small study presented at the American Heart Association's Arteriosclerosis, Thrombosis and Vascular Biology Scientific Sessions 2011.

Etidronate is among a class of drugs called bisphosphonates that are widely used to combat osteoporosis. It's also prescribed for Paget's disease.

In the new research, 251 patients with high levels of cholesterol received either 20 milligrams daily of the cholesterol-lowering drug atorvastatin, or atorvastatin plus 400 milligrams daily of etidronate.

After two years, researchers used magnetic resonance imaging to measure changes in the thickness of the blood vessel wall, and plaque build-up, in the aorta.

Both groups had similar reductions in maximal vessel wall thickness in the thoracic aorta (-13% vs. -15%, p=0.587). But patients on the combination therapy had a 12 percent reduction in maximal vessel wall thickness in the abdominal section of the aorta, compared with only a 1 percent reduction in the group on only the statin (p<0.001).

Furthermore, only 1 percent of the combination therapy group experienced major cardiovascular events, compared with 5 percent of the group receiving the single cholesterol drug (p=0.049). Those events included myocardial infarction, myocardial revascularization, admission to the hospital for an acute coronary syndrome, and death from coronary heart disease.

The authors conclude that atorvastatin plus etidronate combination therapy caused a significant regression of both thoracic and abdominal aortic plaques, whereas atorvastatin monotherapy did only thoracic aortic plaques. In addition, the combination therapy might be superior to atorvastatin monotherapy in decreasing the incidence of cardiovascular events.


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