Atherosclerosis plaque regression

Abstract

The natural history of atherosclerosis can be assessed using different methods including quantitative coronary angiography, intravascular ultrasound, B-mode ultrasound, electron-beam computed tomography and magnetic resonance imaging. Although the first investigations regarding effects of low cholesterol diet on atherosclerosis progression in animals were performed almost 100 years ago, researches on potential induction of atherosclerosis regression in humans began only recently, in the past 20 years. To date, many studies assessing different drugs and study protocols on natural evolution of atherosclerosis have been performed. They include use of diet and physical activity, different hypolipemic drugs, especially statins, ACE inhibitors, calcium channel blockers, hormone replacement therapy, antioxidants, and recently, use of recombinant apolipoproteins. It has been established that statins given to patients with, or even without verified coronary artery disease, slow progression of atherosclerosis. These effects of statins are likely due to a combination of their metabolic and pleiotropic properties and might in part explain the positive effects of these drugs on overall cardiovascular mortality and morbidity. Furthermore, applied in high doses, these drugs may induce real atherosclerosis regression, especially in asymptomatic patients in the early stages of the disease.