Effects of fluvastatin on coronary atherosclerosis in patients with mild to moderate cholesterol elevations (lipoprotein and coronary atherosclerosis study [LCAS])
Effects of fluvastatin on coronary atherosclerosis in patients with mild to moderate cholesterol elevations (lipoprotein and coronary atherosclerosis study [LCAS])
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DOI：
10.1016/s0002-9149(97)00346-9
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发表时间：
1997-08-01
影响因子：
2.8
通讯作者：
Gotto, AM
中科院分区：
文献类型：
--
作者：
Herd, JA;Ballantyne, CM;Gotto, AM
尽管有降低发病率和死亡率的潜力，但对冠心病（CHD）患者轻度至中度高胆固醇血症的积极干预仍存在争议，而且很少实践。2.5年脂蛋白和冠状动脉粥样硬化研究的合格患者为年龄35 - 75岁的男性和女性，血管造影显示CHD，尽管饮食，平均低密度脂蛋白（LDL）胆固醇为115 - 190 mg/dl。患者（n = 429; 19%为女性）随机接受氟伐他汀20 mg每日2次或安慰剂治疗。四分之一的患者还被分配了开放标签的连续性考来烯胺，最高12 g/天，因为随机化前LDL胆固醇仍然大于或等于160 mg/dl。通过定量冠状动脉造影评估的主要终点是患者内符合条件的病变的最小管腔直径（MLD）的变化。在2.5年期间，所有氟伐他汀患者（+/-考来烯胺）的平均LDL胆固醇降低了23.9%（146至111 mg/dl），仅氟伐他汀亚组降低了22.5%（137至106 mg/dl）。主要终点分析（340例患者）显示，所有氟伐他汀组的病变进展显著低于所有安慰剂组，Delta MLD为-0.028 mm vs-0.100 mm（p
Despite the potential for reduced morbidity and mortality, aggressive intervention against mild to moderate hypercholesterolemia in patients with coronary heart disease (CHD) remains controversial and infrequently practiced. Eligible patients in the 2.5-year Lipoprotein and Coronary Atherosclerosis Study were men and women aged 35 to 75 years with angiographic CHD and mean low-density lipoprotein (LDL) cholesterol of 115 to 190 mg/dl despite diet. Patients (n = 429; 19% women) were randomized to fluvastatin 20 mg twice daily or placebo. One fourth of patients were also assigned open-label adjunctive cholestyramine up to 12 g/day because prerandomization LDL cholesterol remained greater than or equal to 160 mg/dl. The primary end point, assessed by quantitative coronary angiography, was within-patient perlesion change in minimum lumen diameter (MLD) of qualifying lesions. Across 2.5 years, mean LDL cholesterol was reduced by 23.9% in all fluvastatin patients (+/- cholestyramine) (146 to 111 mg/dl) and by 22.5% in the fluvastatin only subgroup (137 to 106 mg/dl). Primary end point analysis (340 patients) showed significantly less lesion progression in all fluvastatin versus all placebo patients, Delta MLD -0.028 versus -0.100 mm (p