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Track Your Plaque in the News: Vitamin D and Plaque Regression Data
Progression and Regression of Coronary Calcium Score William R. Davis1 and Susie W. Rockway2 1 Medical
Director, Milwaukee Heart Scan, Wauwatosa, WI ABSTRACT Serial calcium scoring obtained by CT scanning has been proposed as a means of following progression or regression of coronary atherosclerotic plaque. In an open-label study, we combined pharmaceutical lipid treatment with dietary supplementation in patients presenting with coronary calcium (Agatston) scores ≥ 50 to test the impact on progression or regression of annual plaque growth as measured by serial coronary calcium scoring in a cohort of 45 men and women. Treatment included statin therapy, niacin, the American Heart Association Therapeutic Lifestyle Changes (TLC) diet, omega-3 fatty acids and vitamin D-3 supplementation at levels to achieve target fasting lipid values of: LDL cholesterol ≤ 60 mg/dl, HDL ≥ 60 mg/dl and triglycerides of 60 ≤ mg/dl and a serum level of 25-OH-vitamin D3 of ≥ 50 ng/ml. All atherogenic lipids were significantly reduced when tested 1 to 2 years after treatment (p<0.001). Total cholesterol dropped by 23%, LDL-c by 37%, TG by 29% while HDL significantly (p<0.001) increased by 18%. Unexpectedly, 21 subjects demonstrated reduced calcium plaque burden as evidenced by a percent decrease in coronary calcium scores (ranges from 0 to –64%), while 21 experienced slowing of progression (mean 12%), defined as less than 30% increase in calcium score (ranges 0.95% to 29%), while only 3 subjects continued to progress at a rate greater than 30%. In conclusion, though wide variation in response following this approach is seen, substantial regression of atherosclerotic coronary plaque using a CT calcium scoring approach is achievable with treatment efforts that extend beyond LDL cholesterol reduction. Discussion Abstracts are simply meant to telegraph, in the
briefest of words, the results of an experience. There is far more
to this story, of course, that will be related in a future full
publication. (Unfortunately, I cannot say more than that because of
the restrictions placed on discussing soon-to-be-published data. We
will post details at the appropriate time.) 2) Many of the less quantitative, subtle nuances of plaque reversal were not discussed, such as the role of optimism vs. pessimism, blood pressure effects with exercise, inflammatory influences, etc. Such are the limitations of data reporting. 3) As our numbers grow, we will need to re-examine
the experience. Since at this point we are not “blinding” people to
their treatment program, restricting use of other supplements (like
vitamin K2 or phosphatidylcholine), the experience remains “real
world.” It is admittedly not as “clean” as a drug company-sponsored
drug vs. placebo trial. Among the projects for the future is the
Track Your Plaque full spectrum of treatments vs. a statin “control”
group. However, once people hear what the Track Your Plaque
treatment entails, it is very difficult to persuade them to accept a
statin-only treatment program. Nor would a drug company sponsor a
study that is likely to make them look like a distant second choice. Copyright 2008, Track Your Plaque. |
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