Document Detail

Review of cholesterol-lowering therapy: coronary angiographic and events trials.
MedLine Citation:
PMID:  8900335     Owner:  NLM     Status:  MEDLINE    
Coronary angiographic trials have demonstrated that the lowering of cholesterol slows the progression of atherosclerosis, enhances atherosclerotic regression, limits the formation of new lesions, and reduces the incidence of coronary events. Atherosclerotic progression has been shown to be associated with an increased risk of cardiac death, cardiac death plus nonfatal myocardial infarction (MI), and all coronary events. Most of the atherosclerotic regression trials were too small and of too short duration to demonstrate a significant difference in hard coronary events between patients receiving cholesterol-lowering intervention and controls. However, when data from these studies were pooled, total mortality was found to be reduced by 26% and the rate of nonfatal MI by 39% in actively treated patients. The first events trial to demonstrate clearly a reduction in overall mortality was the Scandinavian Simvastatin Survival Study (4S), in which lowering of serum cholesterol in patients with coronary artery disease (CAD) and hypercholesterolemia also reduced coronary mortality, fatal and nonfatal MI, sudden cardiac death, and the need for revascularization. Reductions in major coronary events were seen consistently in all subgroups of patients studied and regardless of concomitant therapy with aspirin, beta blockers, or calcium antagonists. Further evidence of the benefit of cholesterol-lowering therapy was provided by the West of Scotland Coronary Prevention Study (WOSCOPS), which evaluated men with hypercholesterolemia but no history of CAD. Those receiving active treatment had less overall mortality, lower risk of definite nonfatal MI or death from definite or suspected CAD, and less need for revascularization. The Cholesterol and Recurrent Events (CARE) Study recently showed that lipid-lowering therapy is also beneficial in CAD patients with less severe dyslipidemia.
D Waters; T R Pedersen
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  101     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-12-05     Completed Date:  1996-12-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  4A34S-38S; discussion 39S     Citation Subset:  AIM; IM    
Hartford Hospital, Connecticut 06102, USA.
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MeSH Terms
Anticholesteremic Agents / therapeutic use*
Cholesterol, LDL / blood
Clinical Trials as Topic
Coronary Angiography*
Coronary Artery Disease / prevention & control
Coronary Disease / blood,  mortality,  prevention & control*
Disease Progression
Hypercholesterolemia / drug therapy
Survival Rate
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Cholesterol, LDL

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