High dose and long-term statin therapy accelerate coronary artery calcification
Abstract
Background In randomized clinical trials statins and placebo treated patients showed the same degree of coronary artery calcium (CAC) progression. We reanalyzed data from two clinical trials to further investigate the time and dose dependent effects of statins on CAC. Additionally, we investigated whether CAC progression was associated with incident cardiovascular events. Methods and results Data were pooled from two clinical trials: St. Francis Heart Study (SFHS) (419 and 432 patients treated with placebo and 20 mg atorvastatin daily, respectively) and EBEAT Study (164 and 179 patients respectively treated with 10 mg and 80 mg atorvastatin daily). CAC scores were assessed at baseline, 2 years and 4-6 years in SFHS; in EBEAT they were measured at baseline and 12 months. After a short-term follow-up (12 to 24 months) placebo and low dose atorvastatin showed a similar CAC increase, although 80 mg/daily atorvastatin increased CAC an additional 12-14% over placebo (p Conclusions Despite a greater CAC increase with high dose and long-term statin therapy, events did not occur more frequently in statin treated patients. This suggests that CAC growth under treatment with statins represents plaque repair rather than continuing plaque expansion.
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The use of statins can promote calcification of atherosclerotic plaques.
“Recent studies demonstrated that the use of statins can promote calcification of atherosclerotic plaques 29, 48 .”
From Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. (2017) · cites this paper as [48]
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- Authors
- Henein, M., Granåsen, G., Wiklund, U., Schmermund, A., Guerci, A., Erbel, R., & Raggi, P.
- Affiliations
- Umeå University (SE)
- Cardiovascular Center Bethanien (DE)
- St. Francis Hospital (US)
- University of Duisburg-Essen (DE)
- University of Alberta (CA)
- Corresponding author
- Raggi, Paolo
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 184
- Pages
- 581-586
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2000313374
- Cited by
- 181
- References
- 2
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 16 · 2023: 15 · 2022: 17 · 2021: 31 · 2020: 21 · 2019: 15 · 2018: 12 · 2017: 13 · 2016: 18 · 2015: 4
- FWCI
- 15.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- statins, atorvastatin, coronary artery calcification, coronary artery calcium progression, high-intensity statin therapy, dose-dependent effects, long-term statin therapy, cardiovascular events
- MeSH terms
- Aged, Coronary Artery Disease, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Humans, Male, Middle Aged, Time Factors, Disease Progression, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Vascular Calcification
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