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1092.15 |
1 Medical Director, Milwaukee Heart Scan,, Private Practice, Wauwatosa, WI
2 Clinical Nutrition, Rush University Medical Center, Chicago, IL
ABSTRACT
Serial calcium scoring obtained by CT scanning has been proposed as a means of following progression or regression of coronary atherosclerotic plaque. In an open-label study, we combined pharmaceutical lipid treatment with dietary supplementation in patients presenting with coronary calcium (Agatston) scores 
50 to test the impact on progression or regression of annual plaque growth as measured by serial coronary calcium scoring in a cohort of 45 men and women. Treatment included statin therapy, niacin, the American Heart Association Therapeutic Lifestyle Changes (TLC) diet, omega-3 fatty acids and vitamin D-3 supplementation at levels to achieve target fasting lipid values of: LDL cholesterol 
60 mg/dl, HDL 60 mg/dl and triglycerides of 60 mg/dl and a serum level of 25-OH-vitamin D3 of 50 ng/ml. All atherogenic lipids were significantly reduced when tested 1 to 2 years after treatment (p<0.001). Total cholesterol dropped by 23%, LDL-c by 37%, TG by 29% while HDL significantly (p<0.001) increased by 18%. Unexpectedly, 21 subjects demonstrated reduced calcium plaque burden as evidenced by a percent decrease in coronary calcium scores (ranges from 0 to –64%), while 21 experienced slowing of progression (mean 12%), defined as less than 30% increase in calcium score (ranges 0.95% to 29%), while only 3 subjects continued to progress at a rate greater than 30%. In conclusion, though wide variation in response following this approach is seen, substantial regression of atherosclerotic coronary plaque using a CT calcium scoring approach is achievable with treatment efforts that extend beyond LDL cholesterol reduction.
FOOTNOTES
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