Statins Accelerate Coronary Calcification and Reduce the Risk of Cardiovascular Events

Cardiol Rev. 2023 Nov-Dec;31(6):293-298. doi: 10.1097/CRD.0000000000000438. Epub 2022 Jan 6.

Abstract

Lipid-lowering therapy with statins is well recognized as an effective therapy in reducing adverse cardiovascular events. However, the relationship between statin therapy and progression of coronary artery calcification (CAC) is unclear. A few of studies suggested that statins fail to slow and even accelerate progression of CAC; meanwhile, some researchers demonstrate opposite results. With the purpose of seeking out the effect of statin therapy on CAC, we summarized the existing evidence on statins and undertook meta-analyses of clinical trials assessing the effect of statin therapy on CAC. Fourteen trials were identified suitable for inclusion in the analysis of the effect of statin treatment on CAC, of which 11 were randomized controlled trails, 1 was case-control study, 1 was cross-sectional study, and 1 was observational study. In the meta-analysis of CAC progression, statin therapy seemed to accelerate the progression of CAC. Meanwhile, the analysis revealed a significant correlation between statin treatment and lower risk of cardiovascular events. In conclusion, meta-analyses of the available trials have shown a significant reduction of risk of cardiovascular events. In contrast, statins accelerated CAC. This suggests that statin-mediated atheroma calcification may enhance plaque stability and reduce the risk of plaque rupture.

Publication types

  • Meta-Analysis

MeSH terms

  • Case-Control Studies
  • Coronary Artery Disease* / drug therapy
  • Coronary Artery Disease* / prevention & control
  • Cross-Sectional Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Observational Studies as Topic
  • Plaque, Atherosclerotic*
  • Risk Factors
  • Vascular Calcification* / chemically induced
  • Vascular Calcification* / drug therapy
  • Vascular Calcification* / prevention & control

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors