Regression of coronary atherosclerosis during treatment of familial hypercholesterolemia with combined drug regimens.-猫眼课题宝

DOI：

10.1001/jama.1990.03450230043027

发表时间：

1990-12

期刊：

JAMA

影响因子：

通讯作者：

中科院分区：

其他

文献类型：

作者：

J. Kane;M. Malloy;T. Ports;N. Phillips;James C. Diehl;R. Havel

我们对 72 名杂合子家族性高胆固醇血症患者进行了一项随机对照试验，以测试通过饮食和联合药物治疗降低血浆低密度脂蛋白水平是否可以诱导冠状动脉病变消退。在 26 个月的时间间隔之前和之后，通过基于计算机的定量血管造影术测量了 457 个病变。主要结果变量是患者内面积狭窄百分比的平均变化。平均低密度脂蛋白胆固醇水平从 7.32 +/- 1.5 降至 4.45 +/- 1.6 mmol/L。对照组中面积狭窄百分比的平均变化为+0.80，表明进展，而治疗组的平均变化为-1.53，表明消退（组间差异的双尾 t 检验 P = .039）。单独分析的女性回归也很显着。试验中面积狭窄百分比的变化与低密度脂蛋白水平相关。我们的结论是，降低低密度脂蛋白胆固醇水平可以诱导家族性高胆固醇血症患者冠状动脉粥样硬化病变的消退。女性和男性都期望从治疗中获益。

We conducted a randomized, controlled trial in 72 patients with heterozygous familial hypercholesterolemia to test whether reducing plasma low-density lipoprotein levels by diet and combined drug regimens can induce regression of coronary lesions. Four hundred fifty-seven lesions were measured before and after a 26-month interval by computer-based quantitative angiography. The primary outcome variable was within-patient mean change in percent area stenosis. Mean low-density lipoprotein cholesterol levels decreased from 7.32 +/- 1.5 to 4.45 +/- 1.6 mmol/L. The mean change in percent area stenosis among controls was +0.80, indicating progression, while the mean change for the treatment group was -1.53, indicating regression (P = .039 by two-tailed t test for the difference between groups). Regression among women, analyzed separately, was also significant. The change in percent area stenosis was correlated with low-density lipoprotein levels on trial. We conclude that reduction of low-density lipoprotein cholesterol levels can induce regression of atherosclerotic lesions of the coronary arteries in patients with familial hypercholesterolemia. The anticipation of benefit from treatment applies to women and men alike.

Regression of coronary atherosclerosis during treatment of familial hypercholesterolemia with combined drug regimens.

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