The effect of moderate and intensive lipid lowering on plaque progression and arterial remodeling at coronary branch points was investigated. Intensive (+1 ± 19.6%), but not moderate (+4.1 ± 15.1%), lipid lowering prevented an increase in plaque area at the branch points. The 2 strategies were associated with increased areas of the lumen (+7.6% to 9.4%) and external elastic membrane (+9.6% to 10.8%). In contrast, there was no significant change in plaque, lumen, and/or external elastic membrane areas at the nonbranch point site. These results suggest that intensive lipid lowering can have a dramatic effect on atheroma-prone regions and that remodeling in response to changes in plaque is a heterogenous process.