Pravastatin reduces carotid intima-media thickness progression also in patients showing an unsatisfactory response in terms of LDL-C reduction. The CAIUS study

Pravastatin reduces carotid intima-media thickness progression also in patients showing an unsatisfactory response in terms of LDL-C reduction. The CAIUS study D. Baldassarre,1 CR. Sirtori,1 F. Veglia,2 C. Gobbi,2 G. Gallus for the CAIUS Research group. E. Grossi Paoletti Center, Institute of Pharmacological Sciences University of Milan,1 Department of Medical Statistics H.S. Raffaele Milan,2 Italy. The Carotid Atherosclerosis Italian Ultrasound study (CAIUS) is a multicenter, parallel group, double-blind clinical trial, performed in 305 asymptomatic, moderately hypercholesterolemic patients, which demonstrated the beneficial effect of pravastatin on the carotid intima-media thickness progression. We took advantage of the data-base of the study to investigate whether pravastatin is effective in reducing carotid atherosclerosis progression also in patients showing unsatisfactory reduction of LDL-C. Among the 151 patients treated with pravastatin, 122 showed a reduction of LDL-C higher than 10% and were considered “responders”. 16 patients did not respond or showed an unsatisfactory response (LDL-C reduction * 10%) and were classified as “non-responders”. The responders were further stratified according to the time of maintenance of response to treatment. Patients, who mantained the response for the entire follow-up period were classified as “non response losers” (n= 109) while those that after 18 months tended to lose response were classified as “response losers” (n=13). In contrast to what observed in the placebo group, that showed a positive rate of IMT progression, all groups treated with pravastatin, independent of the response in terms of LDL-C reduction, showed negative IMT changes. No significant difference was found between responders and non-responders, as well as between response losers and non response losers. We conclude that the effect of pravastatin on IMT progression is apparently independent of its hypolipidemic effect.