Dyslipidemia, Vascular Atheroma and Statins

Dyslipidemia plays an important role in the initiation and progression of atherosclerotic coronary artery disease. However, regression of atherosclerotic atheroma by introducing lipid lowering agents is not fully understood but looks promising. More questions still need to be answered in terms of the modality of assessment, time course of changes and its documentation, whether plaque progression or regression assessed by imaging one arterial tree reflects a uniform effect throughout all arterial territories and whether atheroma regression is a therapeutic goal. Physicians need to define the type of statins, the use of statin as monotherapy or in combination with other agents, and the intensity of statin therapy. Furthermore, the impact of factors like age, gender and ethnicity on the regression process should be of consideration. We still need more randomized controlled studies based on evidence-based diagnostic interventional tools. This narrative review considers this debate.