EARLY ATHEROSCLEROSIS CHANGE IN TWO CLINICAL TRIALS

本提案的主要目标是：1）完成终点 动脉粥样硬化回归研究（MARS）分析;以及 2)比较冠状动脉与颈动脉的治疗效果关系， MARS与冠状动脉与颈动脉治疗效果的关系 降低胆固醇动脉粥样硬化研究（CLAD）。 火星是一个 随机、双盲、安慰剂对照、血管造影试验 洛伐他汀和膳食降脂效果的比较 270例受试者接受安慰剂治疗。 目标研究人群包括 70岁以下的男性和女性，胆固醇水平从200 至295 mg/dL和两条或多条冠状动脉中的冠状动脉疾病 片段 随访冠状动脉造影分别进行了两次和四次 分别在247例和68例受试者中进行随机化后10年;提供 冠状动脉粥样硬化消退/进展信息 侵入性病变 颈动脉超声图像记录在4 在215名受试者中进行长达4年的时间间隔， 动脉粥样硬化消退/进展信息 （内膜中层厚度）病变与冠状动脉平行 侵入性病变 MARS的独特功能包括：1）同时 冠状动脉造影（通过定量冠状动脉造影评价 (QCA)和小组阅读）和颈动脉超声检查， 200例受试者; 2）评估最大脂蛋白和 载脂蛋白数据收集的血管造影试验的日期。 这 包括广泛的VLDL、LDL、IDL和HDL亚类以及LDL类型 模式、脂蛋白颗粒和载脂蛋白（包括AI，B，CIII， 和E）;以及3）评估饮食对 动脉粥样硬化消退/进展仅在一个其他血管造影 Trail，CLAS. MARS和CLAS的一个独特功能显示了类似的 CLAS样男性（非吸烟男性CABG患者）和女性中的效果。 以来 颈动脉内膜中层厚度、QCA和总体变化评分已被 显示可预测临床冠状动脉事件，了解 这些动脉粥样硬化指标之间的关系可能是重要的， 建立颈动脉内膜中层厚度测量作为替代 测量冠状动脉粥样硬化。

Primary objectives of this proposal are: 1) To complete end point analysis for the Monitored Atherosclerosis Regression Study (MARS); and 2) To compare coronary versus carotid treatment effect relationships in MARS to coronary versus carotid treatment effect relationships in the Cholesterol Lowering Atherosclerosis Study (CLAD). MARS was a randomized, double-blind, placebo-controlled, angiographic trial comparing the effects of lipid lowering by lovastatin and diet with diet plus placebo in 270 subjects. The target study population consisted of males and females under 70 years of age with cholesterol levels from 200 to 295 mg/dL and coronary artery disease in two or more coronary artery segments. Follow-up coronary angiograms were performed two and four years post-randomization in 247 and 68 subjects, respectively; providing information on atherosclerosis regression/progression of coronary artery intrusive lesions. Carotid ultrasound images have been recorded at four month intervals for periods up to four years in 215 subjects providing information on atherosclerosis regression/progression of pre-intrusive (intima-media thickness) lesions in parallel with coronary artery intrusive lesions. Unique features of MARS include: 1) Simultaneous coronary angiography (evaluated both by quantitative coronary angiography (QCA) and panel-reading) and carotid ultrasonography in a cohort of over 200 subjects; 2) The opportunity to evaluate the largest lipoprotein an apolipoprotein data collected in an angiographic trial to date. This includes extensive VLDL, LDL, IDL, and HDL subclasses as well as LDL type pattern, lipoprotein particles and apolipoprotein (including AI, B, CIII, and E); and, 3) The opportunity to evaluate dietary effects on atherosclerosis regression/progression only in one other angiographic trail, CLAS. A unique feature of MARS and CLAS has shown a similar effect in CLAS-like men (non-smoking men with CABG) and women. Since carotid intima-media thickness, QCA, and global change score have been shown to be predictive of clinical coronary events, understanding the relationship between these atherosclerotic measures may be important in establishing carotid intima-media thickness measurements as a proxy measure for coronary atherosclerosis.