Effect of new statin treatment on carotid artery intima-media thickness: A real-life observational study over 10 years

Atherosclerosis. 2020 Aug;306:6-10. doi: 10.1016/j.atherosclerosis.2020.06.012. Epub 2020 Jul 5.


Background and aims: Randomized clinical trials (RCT) have shown statin treatment to slow down the increase in carotid artery intima-media thickness (IMT) seen with ageing. However, those RCTs usually have a limited follow-up (1-3 years). Here an observational study was used to investigate the real-life effect of new statin treatment over a 10-year follow-up.

Methods: In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, 954 individuals all aged 70 years at baseline were investigated regarding carotid artery IMT three times during 10 years (n = 771 at age 75, and n = 591 at age 80).

Results: At age 70, 503 subjects were statin-naïve and did not receive statin during the 10-year follow-up period (the never-statin group), while 197 subjects were statin-naïve but received statins during the follow-up period (the received-statin group). Low-density lipoprotein (LDL)-cholesterol increased over time in the never-statin group (+0.1 mmol/l, p = 0.0012), but decreased in the group receiving statin treatment (-1.1 mmol/l, p < 0.0001). The never-statin group increased significantly in IMT over the 10 years (+0.07 mm, p < 0.0001), while the numerical increase seen in the received-statin group was not significant (+0.02 mm, p = 0.22) A significant difference in the change in IMT over time was seen between the received-statin group and the never-statin group (p < 0.0001 for interaction between time and group, adjusted for a propensity score).

Conclusions: This real-life observational study showed that new statin treatment reduced the increase in IMT seen over 10 years compared to subjects not treated with statins.

Keywords: Atherosclerosis; Intima-media thickness; Longitudinal; Statin; Treatment.