Abstract
Lipid-lowering therapy has a significant impact on the prognosis and clinical course of coronary artery disease (CAD). Slowdown of plaque progression and plaque stabilization are the major cardiac goals of any lipid-lowering strategy. Until now, intravascular ultrasound imaging (IVUS) has been the only in vivo imaging modality which allows serial analysis of plaque burden and plaque composition on a volumetric basis. Several serial IVUS studies have shown that chronic statin therapy could decrease or even halt plaque growth. Moreover, aggressive lipid-lowering therapy using statins changes plaque composition over time. There is evidence that changes in plaque composition might explain the positive prognostic impact of statin therapy in patients with CAD. Beyond clinical endpoint studies, serial volumetric IVUS studies will become the standard to prove the efficacy of new lipid-lowering strategies in the future.