Coronary arteries: a stronger cholesterol regimen shrank more plaque
· BehindLines newsroom
A Danish randomised trial called FLOWPROMOTE reports that pairing rosuvastatin with ezetimibe shrinks the fatty plaque in heart arteries more than a 40 mg dose of atorvastatin alone. The findings, posted online on 30 October 2026 in JAMA Cardiology, were picked up on 5 November by Medical Xpress.
How the trial worked
The analysis covers 104 adults (average age 64, 82 of them men) who had never taken a statin and had newly diagnosed stable coronary artery disease: artery narrowing above 50% on a coronary CT scan and a CT-derived fractional flow reserve of 0.80 or lower. They were assigned at random to two groups of 52 for 18 months, one on atorvastatin 40 mg, the other on rosuvastatin 40 mg plus ezetimibe 10 mg. Coronary CT scans were done at the start, then at 9 and 18 months. These are imaging analyses that had been specified in advance.
The results
LDL cholesterol went from 119.7 to 69.5 mg/dL (down 38%) on atorvastatin and from 127.4 to 42.5 mg/dL (down 65%) on the combination. Total plaque volume fell 21.1% with the combination against 13.6% with atorvastatin (a difference of -30.9 mm³, 95% confidence interval -57.2 to -4.5). Softer, non-calcified plaque dropped 28.2% versus 20.0%. Calcified plaque rose by a similar amount in both groups. Total plaque volume shrank in 90% of patients on the combination (47 of 52) and in 75% of the others (38 of 51 patients analysed). The lower the LDL level reached, the greater the regression.
What remains unknown
The authors conclude that partial reversal of coronary atherosclerosis appears possible. But the trial is small, run in one country, and did not count heart events: Medical Xpress notes that only further research can show whether the plaque reduction means fewer heart attacks or strokes. This article is general information and does not replace a doctor's advice.