Document Detail

Monotherapy with HMG-CoA reductase inhibitors and secondary prevention in coronary artery disease.
MedLine Citation:
PMID:  8874986     Owner:  NLM     Status:  MEDLINE    
Although thrombolytic drugs, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting have provided major advances in the treatment of coronary artery disease, the use of lipid-lowering drugs for secondary prevention has significantly reduced cardiovascular events in the population with coronary artery disease. Secondary prevention trials using HMG-CoA reductase inhibitors include the Familial Atherosclerosis Treatment Study (FATS), the Monitored Atherosclerosis Regression Study (MARS), the Canadian Coronary Atherosclerosis Intervention Trial (CCAIT), the Asymptomatic Carotid Artery Progression Study (ACAPS), the Multi Anti-Atheroma Study (MAAS), the Scandinavian Simvastatin Survival Study (4S), the Pravastatin Limitation of Atherosclerosis in Coronary Arteries (PLAC I), the Regression Growth Evaluation Statin Study (REGRESS), the Pravastatin Multinational Study, and the Pravastatin, Lipids, and Atherosclerosis in Carotids (PLAC II). Mean changes from baseline of lipid fractions in these trials included: total cholesterol 18 to 35% reduction; low-density lipoprotein (LDL) cholesterol 26 to 46% reduction; high-density lipoprotein (HDL) cholesterol 5 to 15% increase; and triglyceride 7 to 22% reduction. Angiographic regression or lack of progression was statistically demonstrated in the FATS, MARS, CCAIT, MAAS, PLAC I, and REGRESS trials. Cardiovascular events decreased 25 to 92% in all trials, and there was a significant reduction in both cardiovascular and total mortality in the 4S. The greater reduction in cardiovascular events than in anatomic changes suggests that the HMG-CoA reductase inhibitors stabilized the surface of plaques. Monotherapy with HMG-CoA reductase inhibitors provides the clinical opportunity to modify the natural history of coronary artery disease.
C E Rackley
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical cardiology     Volume:  19     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1996 Sep 
Date Detail:
Created Date:  1997-01-16     Completed Date:  1997-01-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  683-9     Citation Subset:  IM    
Lipid Disorder Center, Georgetown University Medical Center, Washington, D.C. 20007-2196, USA.
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MeSH Terms
Carotid Artery Diseases / drug therapy
Clinical Trials as Topic
Coronary Artery Disease / drug therapy
Coronary Disease / complications,  drug therapy*,  physiopathology
Enzyme Inhibitors / therapeutic use
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Lovastatin / analogs & derivatives,  therapeutic use
Pravastatin / therapeutic use
Reg. No./Substance:
0/Enzyme Inhibitors; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 75330-75-5/Lovastatin; 79902-63-9/Simvastatin; 81093-37-0/Pravastatin

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