Taking a statin can help stabilize coronary artery plaque, reducing the risk of heart attack and stroke. The large REPRIEVE trial showed that middle-aged HIV-positive people with low to moderate cardiovascular risk scores who took daily pitavastatin (Livalo) reduced their risk for major cardiovascular events by 35%. Statins lower LDL cholesterol, which contributes to the buildup of plaque in arteries, or atherosclerosis. Unstable plaque can break off, causing clots that block blood vessels supplying the heart and brain. A REPRIEVE substudy found that the statin reduced the volume of noncalcified plaque in arteries. In a post hoc analysis, 558 participants underwent coronary CT angiography scans and protein and gene expression analysis at baseline and after two years. Those randomized to pitavastatin had higher levels of the enzyme PCOLCE, which controls deposition of collagen, a component of plaque. Changes in PCOLCE were associated with reduced noncalcified plaque volume and altered composition, suggesting plaque stabilization. More stable plaque is less likely to rupture and block blood flow.