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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