Rosuvastatin Slows Progression of Carotid Intima-Media Thickness

Highlights

This multicenter randomized trial called METEOR investigated the efficacy of rosuvastatin in the treatment of subclinical or covert atherosclerosis by using a surrogate marker, carotid intima-media thickness (CIMT). Study participants received 20 mg/day of rosuvastatin (considered a high-dose statin; n = 272) or placebo (n = 271) for 2 years, and ultrasound-based CIMT measurements were obtained at different times during the study period. study. The change in mean CIMT (measured at different sites of the carotid artery) was significantly lower (less covert atherosclerosis) in the rosuvastatin group than in the placebo group (P = 0.02). The safety profile of the drug was similar to that observed in real-life practice.
This study provides evidence that rosuvastatin slows the progression of covert atherosclerosis in the carotid artery. The study findings align with current practice, which encourages high-dose statin treatment in atherosclerotic disease in cardiovascular and cerebrovascular disorders.

The METEOR-China randomized controlled trial (RCT) demonstrated that rosuvastatin 20 mg/day significantly reduced rates of carotid intima-media thickness (cIMT) progression compared with placebo over a 2-year period in Chinese adults with subclinical atherosclerosis.

Statins exert a beneficial effect on cIMT progression and rates of stroke/cardiovascular events in high-risk patients (eg, those with coronary heart disease 6 or recent stroke/transient ischemic attack).

Rosuvastatin Slows Progression of Carotid Intima-M

Background

Atherosclerosis is the leading cause of cardiovascular disease worldwide, including in China. Primary prevention, through lipid reduction, could prevent the development of atherosclerosis. Carotid intima-media thickness (CIMT) is a well-validated measure of atherosclerosis used in intervention studies as a primary outcome and surrogate endpoint for cardiovascular disease events.

Methods

This randomized, double-blind, placebo-controlled, multicenter, parallel-group study evaluated the effects of rosuvastatin 20 mg/d compared with placebo on CIMT progression over 104 weeks in Chinese people with subclinical atherosclerosis.

The primary endpoint was the annualized rate of change in the mean of maximum CIMT measurements taken 7 times during the study period from each of the 12 carotid artery sites (near and far walls of the right and left, carotid bulb and internal carotid artery). carotid artery).

Secondary endpoints included changes in CIMT at different arterial sites and changes in lipid parameters. Safety was also evaluated.

Results

Participants were randomized (1:1) to receive rosuvastatin (n=272) or placebo (n=271). Baseline characteristics were well balanced between groups.

The change in mean maximum CIMT of the 12 carotid sites was 0.0038 mm/a (95% CI, -0.0023-0.0100) for the rosuvastatin group versus 0.0142 mm/a ( 95% CI, 0.0080-0.0204) for the placebo group, with a difference of -0.0103 mm/year (95% CI, -0.0191 to -0.0016; P = 0.020) .

For CIMT secondary endpoints, results were generally consistent with the primary endpoint. There were clinically relevant improvements in lipid parameters with rosuvastatin. We observed an adverse event profile consistent with the known safety profile of rosuvastatin.

Conclusions

Rosuvastatin 20 mg/d significantly reduced CIMT progression over 2 years in Chinese adults with subclinical atherosclerosis and was well tolerated.

Rosuvastatin Slows Progression of Carotid Intima-Media Thickness

Rosuvastatin slows the progression of atherosclerosis in the carotid artery.