Effect of Intensive Compared With Moderate Lipid-Lowering Therapy on Progression of Coronary Atherosclerosis
| Autor: | Steven E. Nissen, E. Murat Tuzcu, Paul Schoenhagen, B. Greg Brown, Peter Ganz, Robert A. Vogel, Tim Crowe, Gail Howard, Christopher J. Cooper, Bruce Brodie, Cindy L. Grines, Anthony N. DeMaria, null for the REVERSAL Investigators |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Atorvastatin Coronary Artery Disease Coronary artery disease chemistry.chemical_compound Double-Blind Method Liver Function Tests Internal medicine Intravascular ultrasound medicine Humans Pyrroles Ultrasonography Interventional Coronary atherosclerosis Pravastatin Observer Variation medicine.diagnostic_test biology business.industry Cholesterol Anticholesteremic Agents Cholesterol HDL C-reactive protein Cholesterol LDL General Medicine Middle Aged medicine.disease Coronary Vessels Surgery C-Reactive Protein Atheroma chemistry Heptanoic Acids Disease Progression Cardiology biology.protein Female lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors business medicine.drug |
| Zdroj: | JAMA. 291:1071 |
| ISSN: | 0098-7484 |
| Popis: | ContextStatin drugs reduce both atherogenic lipoproteins and cardiovascular morbidity and mortality. However, the optimal strategy and target level for lipid reduction remain uncertain.ObjectiveTo compare the effect of regimens designed to produce intensive lipid lowering or moderate lipid lowering on coronary artery atheroma burden and progression.Design, Setting, and PatientsDouble-blind, randomized active control multicenter trial (Reversal of Atherosclerosis with Aggressive Lipid Lowering [REVERSAL]) performed at 34 community and tertiary care centers in the United States comparing the effects of 2 different statins administered for 18 months. Intravascular ultrasound was used to measure progression of atherosclerosis. Between June 1999 and September 2001, 654 patients were randomized and received study drug; 502 had evaluable intravascular ultrasound examinations at baseline and after 18 months of treatment.InterventionsPatients were randomly assigned to receive a moderate lipid-lowering regimen consisting of 40 mg of pravastatin or an intensive lipid-lowering regimen consisting of 80 mg of atorvastatin.Main Outcome MeasuresThe primary efficacy parameter was the percentage change in atheroma volume (follow-up minus baseline).ResultsBaseline low-density lipoprotein cholesterol level (mean, 150.2 mg/dL [3.89 mmol/L] in both treatment groups) was reduced to 110 mg/dL (2.85 mmol/L) in the pravastatin group and to 79 mg/dL (2.05 mmol/L) in the atorvastatin group (P |
| Databáze: | OpenAIRE |
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