THE EFFECT OF CHOLESTEROL-LOWERING AND ANTIOXIDANT THERAPY ON ENDOTHELIUM-DEPENDENT CORONARY VASOMOTION
THE EFFECT OF CHOLESTEROL-LOWERING AND ANTIOXIDANT THERAPY ON ENDOTHELIUM-DEPENDENT CORONARY VASOMOTION
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DOI：
10.1056/nejm199502233320802
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发表时间：
1995-02-23
影响因子：
158.5
通讯作者：
GANZ, P
中科院分区：
文献类型：
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作者：
ANDERSON, TJ;MEREDITH, IT;GANZ, P
背景冠心病合并血脂异常的患者常伴有血管内皮舒张功能障碍，可能导致缺血性心脏事件。降胆固醇或抗氧化治疗是否能恢复内皮依赖性冠状动脉血管舒张功能尚不清楚。我们随机分配了49名患者（平均[+/-SD]血清胆固醇水平，209+/-33 mg/dl [5.40+/-0.85 mmol/L]）接受以下三种治疗之一：美国心脏协会第1步饮食饮食组11例，洛伐他汀和消胆胺（低密度脂蛋白[LDL]降低组，21例）或洛伐他汀和普罗布考（LDL降低抗氧化剂组，17例）。在基线和治疗一年后，对冠状动脉内注入乙酰胆碱（10（-8）至10（-6）M）后的内皮依赖性冠状动脉血管运动进行评估。血管收缩反应，这些剂量的乙酰胆碱被认为是异常的。治疗导致LDL胆固醇水平显著降低，在LDL降低-抗氧化剂组中为41+/-22%，在LDL降低组中为38+/-20%（P
Background. Patients with coronary artery disease and abnormalities of serum lipid levels often have endothelial vasodilator dysfunction, which may contribute to ischemic cardiac events. Whether cholesterol-lowering or antioxidant therapy can restore endothelium-dependent coronary vasodilatation is unknown.Methods. We randomly assigned 49 patients (mean [+/-SD] serum cholesterol level, 209+/-33 mg per deciliter [5.40+/-0.85 mmol per liter]) to receive one of three treatments: an American Heart Association Step 1 diet (the diet group, 11 patients); lovastatin and cholestyramine (the low-density lipoprotein [LDL]-lowering group, 21 patients); or lovastatin and probucol (the LDL-lowering-antioxidant group, 17 patients). Endothelium-dependent coronary-artery vasomotion in response to an intracoronary infusion of acetylcholine (10(-8) to 10(-6) M) was assessed at base line and after one year of therapy. Vasoconstrictor responses to these doses of acetylcholine are considered to be abnormal.Results. Treatment resulted in significant reductions in LDL cholesterol levels of 41+/-22 percent in the LDL-lowering-antioxidant group and 38+/-20 percent in the LDL-lowering group (P