EVALUATION OF SIMVASTATIN TREATMENT TO RETARD PROGRESS OF CORONARY CALCIFICATION

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Purpose: The purpose of the study is to see whether helical computed tomography(HCT)can be used to look at heart arteries for worsening of coronary artery calcification(CAC), and whether treatment with simvastatin will slow down the progression of CAC in heart arteries. Subjects: We will randomize 80 patients, ages 21 through 75, with evidence of coronary calcification (by HCT screening exam) and a cholesterol level that is above average but not at a level that would warrant treatment according to current guidelines. Methods and Measures: After appropriate dietary counseling, 80 patients will be randomized to blinded treatment with one of two therapies: 40mg titrated to 80mg of simvastatin daily or placebo. Patients will be followed for 1 year with clinic visits, quantification of plasma lipids and lipoproteins at baseline, 1,3,6,9 and 12 months, and quantification of coronary artery calcification at baseline, 6 months and 1 year. The primary outcome variable will be progression of coronary calcification over one year. Benefits: The aim of this program is to develop a new minimally invasive method for testing efficacy of drugs with potential for reducing the risk of heart attack. If we can develop such a new method, it will be possible to more rapidly identify patients who will benefit most from medications.