Since the initial report by Sones and Shirey in 1962,1 coronary angiography has been the standard method used to define the severity and extent of coronary atherosclerosis. By only providing a silhouette of the coronary lumen, however, coronary angiography frequently underestimates the true burden of atheroma in the arterial wall. In this issue of JAMA, Nissen et al present important new data on coronary atherosclerosis based on their findings from the ASTEROID (A Study To Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden) trial.2 This multicenter, intravascular ultrasound (IVUS) study assessed the extent of coronary atheroma at baseline and after 2 years of treatment with the maximally approved dose (40 mg) of rosuvastatin, the statin most effective at reducing levels of low-density lipoprotein cholesterol (LDL-C). Each pair of baseline and 24-month IVUS studies was analyzed in blinded fashion.
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