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Methods Thirty eight patients with mild-to-moderate symptomatic PAD (mean age 64 ± 10 years, ankle brachial index 0.70 ± 0.13) were followed for two years on lipid lowering therapy. Statin-naive patients were randomized to simvastatin 40 mg or simvastatin 40 mg plus ezetimibe 10 mg (R group, n = 20). Those already on a statin were given openlabel ezetimibe 10 mg (Z group, n = 18). Patients had the first 15-20 cm of the SFA in their most symptomatic leg imaged with black blood multi-slice turbo spin echo CMR annually (Figure 1). Plaque volume (PV) defined as total vessel volume (TVV) minus lumen volume was measured. Changes in parameters within the R and Z groups over the two years were analyzed with one way ANOVA and between group changes were compared with an unpaired t-test. Results R group designation remains blinded until 2-year followup is finished. LDL at baseline in R was 119 ± 43 mg/dl and fell significantly at one year (81 ± 38, p < 0.001) and remained decreased at two years (83 ± 45). The LDL in Z at baseline was 98 ± 27 mg/dl, decreased significantly at one year (74 ± 35, p = 0.005), and was similar at year 2 (76 ± 27). Total cholesterol changes were similar in both groups. The baseline LDL and total cholesterol in R were greater than Z (p = 0.04 and p = 0.05 respectively), however the year 1 and 2 values were similar between groups. See Table 1 for absolute changes in plaque volume and TVV over time. When expressed as % change over 2 years from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010

Type of lipid lowering therapy impacts atherosclerosis progression in peripheral arterial disease as assessed by CMR