Abstract
Introduction: Lipid lowering drugs are some of the most prescribed medications to control coronary artery disease (CAD). The long-term lipid lowering effects on coronary artery calcium (CAC) progression remain a subject of controversy with inconclusive results from multiple literature reviews. The purpose of this meta-analysis is to elucidate the relationship between lipid control and CAC progression. Methods: A computerized search of MEDLINE was conducted using the search terms “coronary”, “calcification”, “statin”, and “lipid lowering.” Search filters included studies in English performed on human subjects, clinical trials, and journal articles. Studies were included if they measured mean value changes from baseline in coronary calcium using cardiac computed tomography. Data were extracted from the articles according to the Cochrane manual. RevMan 5.4 was used to aggregate the studies and report statistics. Results: A total of 13 studies were included with a total of 6671 patients. LDL reduction amongst the studies was significant as compared to placebo or lower dose lipid lowering therapy (standardized mean difference [SMD]: -0.71; 95% CI: -0.79, -0.64; p<0.00001). Study heterogeneity was not significant amongst the CAC progression studies (p=0.19). An increase in CAC was statistically significant (standardized mean difference [SMD]: 0.10; 95% CI: 0.02, 0.17; p=0.009). Conclusion: Lipid lowering therapy shows efficacy in LDL reduction however, it does not lead to coronary calcium reduction. Further studies are needed to elucidate the long-term effects of lipid powering on CAC and the prognostic value of CAC in CAD parents receiving optimal therapy.
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