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Rekhraj S - - 1999
Plasma lipids play a key role in the development of atherosclerosis. Recent trial data support early identification of asymptomatic adults with high-risk lipid profiles for primary prevention of coronary heart disease. 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors have been shown to reduce coronary events in both asymptomatic adults and those with ...
Duriez P - - 1999
Hypertriglyceridemia is now recognized as an independent risk factor of coronary artery disease (CAD). A recent secondary prevention study of CAD with a statin suggested that it may be prudent to target fasting triglycerides to less than 150 mg/dL. Secondary prevention trials of CAD with drugs acting primarily on triglycerides ...
Dupuis J - - 1999
BACKGROUND: Cholesterol lowering reduces coronary events. One mechanism could be improvement of endothelial function. In line with this hypothesis, this study investigates whether cholesterol reduction can result in rapid improvement of endothelial function after acute coronary syndromes. METHODS AND RESULTS: Patients with acute myocardial infarction or unstable angina and total ...
Baller D - - 1999
BACKGROUND: Early stages of coronary atherosclerosis are characterized by a mainly functional impairment of coronary vasodilator capacity under the impact of such risk factors as hypercholesterolemia. The goal of this study was to determine whether 6-month cholesterol-lowering therapy improves coronary flow reserve in patients with angina, reduced flow reserve despite ...
Kugiyama K - - 1999
BACKGROUND: Remnant lipoproteins are atherogenic, but assays of remnants have not been available in routine clinical laboratories because of the lack of practical and validated methods. A simple and reliable method for such an assay, using an immunochemical approach, has recently been developed. This study prospectively examined whether remnant lipoprotein ...
Caligiuri G - - 1999
Myocardial infarction is linked to atherosclerosis, yet the sequence leading from silent coronary atherosclerosis to acute myocardial infarction has remained unclear. Here we show that hypercholesterolemic apolipoprotein E-/- low density lipoprotein receptor-/- mice develop not only coronary atherosclerosis but also myocardial infarction. Exposure of mice to mental stress or hypoxia ...
Feder G G Department of General Practice and Primary Care, St Bartholomew's and the Royal London Hospital Medical School, Queen Mary and Westfield College, London E1 4NS. - - 1999
To determine whether postal prompts to patients who have survived an acute coronary event and to their general practitioners improve secondary prevention of coronary heart disease. Randomised controlled trial. 52 general practices in east London, 44 of which had received facilitation of local guidelines for coronary heart disease. 328 patients ...
Harris W S - - 1999
Early studies in Greenland Eskimos stimulated interest in evaluating the effect of Omega-3 fatty acids on coronary artery disease. Subsequent studies showed a significant decrease in triglyceride levels in patients receiving high doses of fish oil containing DHA and EPA. Slight increases in LDL were also observed in patients receiving ...
Packard C J - - 1999
Further understanding of the causative link between plasma lipids and coronary heart disease will come from a deeper appreciation of the impact of lipoprotein heterogeneity on the processes of atherosclerosis and thrombosis. It is now widely appreciated that remnants of triglyceride-rich lipoproteins, IDL and specific LDL subfractions may have a ...
de Divitiis M - - 1999
Despite the strong evidence that cholesterol-lowering treatment is effective in the primary and secondary prevention of coronary heart disease, there is a great discrepancy between the results relating to prognosis and the ability of this treatment to induce regression of coronary atheromatous plaques. Since hypercholesterolemia causes a dysfunction in vascular ...
Kwon H M - - 1999
The external elastic lamina (EEL) serves as a barrier for cells and macromolecules between the media and adventitia in the vascular wall. We evaluated the morphological changes and quantitative assessments of the EEL architecture in the coronary circulation of pigs fed with a high cholesterol diet. Confocal microscopy analysis of ...
Moss A J - - 1999
BACKGROUND: Thrombosis is a pivotal event in the pathogenesis of coronary disease. We hypothesized that the presence of blood factors that reflect enhanced thrombogenic activity would be associated with an increased risk of recurrent coronary events during long-term follow-up of patients who have recovered from myocardial infarction. METHODS AND RESULTS: ...
Rader D J - - 1999
Low levels of high-density lipoprotein (HDL) cholesterol are associated with an increased risk of coronary artery disease events. Data in animals indicate that increasing HDL cholesterol levels decreases progression of atherosclerosis. Some clinical trials suggest a benefit from increasing HDL cholesterol levels, but additional data in humans are needed. Nevertheless, ...
Kastelein J J - - 1999
Evidence from epidemiological and clinical studies continues to improve our understanding of the pathogenesis of coronary heart disease (CHD). However, despite major advances in the development of diagnostic methods and effective treatment, CHD remains the leading cause of mortality in the Western world. That cholesterol lowering is of major importance ...
Bo M - - 1999
We investigated the association of total serum cholesterol concentrations and subsequent overall and coronary mortality in 304 patients aged > or =65 discharged from hospital after acute myocardial infarction. There was no association between total cholesterol concentrations and mortality due to either coronary heart disease or to all causes in ...
- - 1999
In observational studies, prolonged lower blood total cholesterol levels - down at least to 3 mmol. l-1 - are associated with lower risks of coronary heart disease. Cholesterol-lowering therapy may, therefore, be worthwhile for individuals at high risk of coronary heart disease events irrespective of their presenting cholesterol levels. Observational ...
Zambon A - - 1999
BACKGROUND: Small, dense LDL particles are associated with coronary artery disease (CAD) and predict angiographic changes in response to lipid-lowering therapy. Intensive lipid-lowering therapy in the Familial Atherosclerosis Treatment Study (FATS) resulted in significant improvement in CAD. This study examines the relationship among LDL density, hepatic lipase (HL), and CAD ...
McCauley K M - - 1999
This article presents a case study of a 16-year-old male patient with a significant family history for hypercholesterolemia and coronary artery disease, who suffered an anterior lateral myocardial infarction. On admission, his electrocardiograms revealed the classic pattern of an anterior lateral acute myocardial infarction plus a left anterior hemiblock. His ...
McPherson R - - 1999
Data from a number of population-based primary prevention trials clearly indicate that reducing total serum cholesterol levels leads to a reduced risk of coronary artery disease and death. Similarly, for patients with coronary artery disease, reducing total serum cholesterol levels proved to be an effective secondary prevention strategy, leading to ...
Langtry H D - - 1999
Fluvastatin is an HMG-CoA reductase inhibitor used to treat patients with hypercholesterolaemia. Since fluvastatin was last reviewed in Drugs, trials have shown its efficacy in the secondary prevention of coronary heart disease (CHD) events and death and have expanded knowledge of its effects in primary CHD prevention and its mechanisms ...
Bux-Gewehr I - - 1999
A 35 year old woman presented with acute myocardial infarction without any of the usual risk factors: she had never smoked; she had normal blood pressure; she did not have diabetes; plasma concentrations of total cholesterol and high and low density lipoprotein cholesterol, fibrinogen, homocysteine, and Lp(a) lipoprotein were normal. ...
Guethlin M - - 1999
BACKGROUND: Lipid-lowering therapy can improve endothelial function in patients with coronary artery disease (CAD) and hypercholesterolemia. Little is known about induced changes in myocardial microcirculation. This study prospectively investigated the temporal effects of lipid-lowering therapy with fluvastatin on coronary flow and flow reserve (CFR) in patients with CAD assessed by ...
Abdelmouttaleb I - - 1999
BACKGROUND: Inflammation might promote the development of atherosclerosis, and high levels of C-reactive protein (CRP) and fibrinogen are associated with an increased risk of acute coronary events. OBJECTIVE: We assessed the levels of CRP and other risk factors in patients with angiographically documented coronary artery disease compared with healthy volunteers ...
Pfohl M - - 1999
Acute myocardial infarction is associated with profound alterations in the plasma lipoprotein profile. The mechanism of these alterations is not clear, and both cholesterol biosynthesis up- and downregulation could possibly be a consequence of acute myocardial infarction. We determined plasma lipids, lipoproteins, apolipoproteins, and lathosterol-which is regarded as an estimate ...
Sacks F M - - 1999
The plasma LDL concentration in firmly established as a cause of coronary heart disease. However, the efficacy of LDL lowering may reach a limit when it is brought well below average during treatment. The Cholesterol and Recurrent Events (CARE) trial compared pravastatin and placebo in patients who had experienced myocardial ...
Plehn J F - - 1999
BACKGROUND: The role of lipid modification in stroke prevention is controversial, although increasing evidence suggests that HMG-CoA reductase inhibition may reduce cerebrovascular events in patients with prevalent coronary artery disease. METHODS AND RESULTS: To test the hypothesis that cholesterol reduction with pravastatin may reduce stroke incidence after myocardial infarction, we ...
Clemetson C A - - 1999
Vitamin C-deficiency is known to cause a disturbance of cholesterol metabolism. Suboptimal plasma ascorbic acid levels also cause increased blood histamine levels, which are exaggerated by sleep-lack and other forms of stress. Histaminemia causes separation of vascular endothelial cells. It is here suggested that the histaminemia of stress and ascorbate ...
Mooney A - - 1999
The statin trials in secondary and primary prevention have shown that lowering LDL cholesterol produces a reduction in coronary event rates of around 35%. The most common dyslipidaemia in MI survivors is mixed hyperlipidaemia rather than hypercholesterolaemia. New evidence from VA-HIT and BIPS suggests that relatively low levels of triglyceride ...
Mahajan A S - - 1999
The effect of yogic lifestyle on the lipid status was studied in angina patients and normal subjects with risk factors of coronary artery disease. The parameters included the body weight, estimation of serum cholesterol, triglycerides, HDL, LDL and the cholesterol - HDL ratio. A baseline evaluation was done and then ...
Jaeger B R - - 1999
Cerebral and myocardial infarctions share common aspects of pathobiochemistry. The central problem is the oxygen supply of the infarcted region. To maintain this supply, H.E.L.P.-apheresis (Heparin-mediated Extracorporeal LDL/Fibrinogen Precipitation) has already proven beneficial in the prevention and therapy of myocardial infarction. Since H.E.L.P.-apheresis can lower significantly plasma viscosity and erythrocyte ...
Wijesinghe L D - - 1999
Raised serum total cholesterol (TC) is an accepted risk factor for both coronary and peripheral vascular disease and three landmark trials have shown the benefit of lowering TC using statins. Vascular surgeons tend to measure TC, but little is known about how they manage hypercholesterolaemia or whether they believe treatment ...
Saia F - - 1998
There are clear benefits in treating hypercholesterolaemia in patients with ischaemic heart disease, especially those with previous myocardial infarction. Following publication of trial evidence and treatment guidelines for hypercholesterolaemia, we investigated the current practice of the management of hypercholesterolaemia in patients with coronary artery disease referred for coronary angiography by ...
Guyton J R - - 1998
Niacin has been studied in 6 major clinical trials with cardiovascular endpoints. The Coronary Drug Project (CDP) was the largest of these trials and the only one to use niacin monotherapy affecting cardiovascular outcomes: recurrent myocardial infarction and cerebrovascular events were significantly decreased. After long-term (15 years) follow-up, total mortality ...
Mabuchi H - - 1998
Familial hypercholesterolemia (FH) is characterized by severe hypercholesterolemia and premature coronary heart disease (CHD). The lower the plasma cholesterol level, the more likely it is that CHD can be prevented or retarded; aggressive cholesterol-lowering therapies may be indicated for FH patients with CHD. This study describes the long-term (6 years) ...
Gidding S S - - 1998
BACKGROUND: Because of the success of secondary prevention of coronary events by intense risk factor modification, a more precise measure of atherosclerosis in youth would have great clinical value both in the design of clinical trials for the demonstration of the usefulness of coronary disease prevention early in life and ...
Kornitzer M - - 1998
Most probably the decennia of the 1990s will be called the 'statin decennia' in the history of coronary heart disease prevention. Statins are effective, both in primary and secondary prevention of coronary heart disease, in middle-aged and older (< 76 years) men and women, in both diabetics and non-diabetics with ...
Pritzker L B - - 1998
Historically, a wide range of drugs have been used to treat hyperlipidemias. These include fibrates whose main action is to lower plasma triglycerides; bile-acid sequestering resins introduced to reduce plasma cholesterol; and more recently a family of statins designed to inhibit the rate-limiting enzyme of cholesterol biosynthesis, HMG-CoA reductase. Early ...
Huse D M - - 1998
Currently, 6 hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are marketed in the United States (US). Given the wide variation in the prices and efficacy of statins, formal cost-effectiveness analysis may improve drug selection decisions. To assess the cost-effectiveness of statin therapy in primary and secondary prevention of coronary heart ...
Shepherd J - - 1998
The effectiveness of plasma cholesterol reduction therapy is no longer in question. Recent studies of cholesterol-lowering drug therapy demonstrate significant reductions in risks of mortality and coronary events in patients with existing coronary artery disease. The West of Scotland Coronary Prevention Study (WOSCOPS) demonstrated the therapy's effectiveness as primary prevention ...
Castelli W P - - 1998
Our understanding of coronary artery disease risk and the atherosclerotic process has changed greatly in recent years. For example, it is now known that angiographically apparent coronary artery plaque is not the major cause of myocardial infarction (MI). Rather, it is unstable, soft plaque that cannot be seen angiographically that ...
Pedersen T R - - 1998
Although hyperlipidemia is a known risk factor for coronary artery disease, lipid-lowering agents were not used widely until recently because evidence was lacking that they could prolong life. In 1987, a large clinical trial, the Scandinavian Simvastatin Survival Study (4S), was designed to test whether such therapy could decrease all-cause ...
Ruotolo G - - 1998
OBJECTIVES: To investigate the mechanisms by which bezafibrate retarded the progression of coronary lesions in the Bezafibrate Coronary Atherosclerosis Intervention Trial (BECAIT), we examined the relationships of on-trial lipoproteins and lipoprotein subfractions to the angiographic outcome measurements. BACKGROUND: BECAIT, the first double-blind, placebo-controlled, randomized serial angiographic trial of a fibrate ...
- - 1998
BACKGROUND: In patients with coronary heart disease and a broad range of cholesterol levels, cholesterol-lowering therapy reduces the risk of coronary events, but the effects on mortality from coronary heart disease and overall mortality have remained uncertain. METHODS: In a double-blind, randomized trial, we compared the effects of pravastatin (40 ...
Lewis S J - - 1998
BACKGROUND: A majority of all myocardial infarctions occur in patients who are 65 years of age or older and have average cholesterol levels, but little information is available on whether cholesterol lowering in such patients reduces the rate of recurrent cardiovascular disease. OBJECTIVE: To determine whether pravastatin reduces the rate ...
Jankowski J - - 1998
1. In this study we compared the 500 MHz 1H-NMRs from native and oxidized low-density lipoproteins. 2. The measurements revealed a characteristic pattern of three resonances in spectra from oxidized, but not from native low-density lipoprotein at 1.17 p.p.m., 1.18 p.p.m. and 1.20 p.p.m. (relative to 3-trimethylsilyl-[2,2,3, 3-2H4]-propionate).3.A quantitative comparison ...
Faergeman O - - 1998
AIM: To assess differences in treatment of ischaemic heart disease in the Scandinavian countries. METHODS AND RESULTS: The Scandinavian Simvastatin Survival Study (4S) lasted 5.4 years and showed that death rates in 4444 patients with coronary heart disease were 30% lower in those treated with simvastatin to lower serum cholesterol ...
Khong T K - - 1998
Treatment with a HMG-CoA reductase inhibitor (statin) following a myocardial infarction has been shown to reduce the incidence of subsequent coronary revascularisation, myocardial infarction and cardiovascular death. The majority (89%) of patients admitted to the coronary care unit of our hospital received a fasting cholesterol check as part of a ...
Wheeler D C - - 1998
Recent clinical trials have demonstrated beyond doubt that statins are effective in the prevention of acute coronary events. Critical analysis of these studies suggests that the benefits of statin therapy cannot be fully explained on the basis of reductions in plasma cholesterol levels. Accumulating knowledge of the actions of these ...
Kitajima S S Center for Laboratory Animals, Saga Medical School, - - 1998
In the present study we macroscopically examined a change in the distribution of coronary atherosclerosis in cholesterol-fed rabbits. Rabbits were fed a cholesterol-enriched diet for 15 weeks, then replaced by a normal diet, and were sacrificed at 15, 24, 32 and 42 weeks after the start of the experiment. The ...
Herd J A - - 1998
Studies of lipid-modifying therapy show that inhibition of cholesterol synthesis is required in at least 2 sites-in hepatic cells and in cells located in the walls of coronary arteries-if the progression of coronary atherosclerosis is to be decreased in patients with relatively normal levels of low-density lipoprotein (LDL) cholesterol. This ...
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