Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B

Article Abstract:

The effects of treating elevated blood levels of fats (lipids) on cardiovascular disease was evaluated in a group of 146 men under the age of 62. All subjects had elevated levels of apolipoprotein B, a protein-lipid complex associated with cholesterol. After all patients received dietary counseling, they were randomly assigned to receive either lovastatin and colestipol, drugs that lower lipid concentrations; niacin, a vitamin, and colestipol; or placebo (these subjects were also given colestipol if their low-density lipoprotein was very high). Levels of lipoproteins, cholesterol, and triglycerides (fat-containing substances in the blood) were evaluated at regular intervals for two-and-one-half-years. The subjects' coronary arteries, the arteries that deliver blood to the heart, were examined at the beginning and end of the study with angiography, X-ray studies of the arteries injected with a dye. Results for the 120 men who completed the study showed that the baseline total cholesterol level for all patients was 6.99 millimoles per liter (270 milligrams per deciliter). This level fell to 6.55, 5.41, and 4.71 millimoles per liter for subjects receiving placebo, niacin and colestipol, or lovastatin-colestipol, respectively. Levels of lipoproteins, the substances to which cholesterol is attached, changed in a favorable manner for the two groups receiving drugs, but not for the placebo group. The subjects in the latter group had an average 2.1 percent increase in the stenosis index, a measure of artery constriction, while treatment with niacin and colestipol led to a decrease of 0.9 percent; with lovastatin and colestipol therapy, the decrease was similar at 0.7 percent. Cardiac events including death, heart attack, or symptoms of newly compromised blood flow to the heart, occurred in 15 patients, 10 of whom were in the placebo group. Only three patients in the lovastatin-colestipol group had a cardiac event. However, this group had the only two heart attacks of the total group; one of these patients died. The results indicate that drug treatment that lowers blood lipid levels reduces the frequency and severity of coronary lesions and the occurrence of cardiovascular events. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Prevention, Physiological aspects, Blood lipids, Lipoproteins, Blood lipoproteins, Coronary arteries, Lovastatin, Colestipol

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Effects of lowering elevated LDL cholesterol on the cardiovascular risk of lipoprotein(a)

Article Abstract:

Lipoprotein(a) appears to be a risk factor for cardiovascular disease only in the presence of elevated low-density lipoprotein (LDL)-cholesterol. Lipoprotein(a) and LDL are similar chemicals that are believed to pose a risk of cardiovascular disease. Researchers used coronary angiography to follow disease progression in 146 men who were being treated for coronary artery disease (CAD). The men followed the American Heart Association's Step II diet and took a variety of cholesterol-lowering drugs including lovastatin, colestipol and niacin. The severity of CAD and the frequency of heart attack or angina was greater in those who had elevated lipoprotein(a). However, disease severity and number of cardiac events were significantly reduced in men whose LDL-cholesterol was lowered even though they still had elevated lipoprotein(a). This indicates that lipoprotein(a) requires LDL-cholesterol for its adverse health effects.

Development and progression, Cholesterol, LDL, VLDL cholesterol lipoproteins, Lipoprotein A

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Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease

Article Abstract:

The B vitamin niacin when combined with the cholesterol-lowering drug simvastatin appears to prevent the progression of coronary artery disease, according to a study of 160 patients. The treatment also lowered blood levels of LDL, or 'bad' cholesterol, and increased blood levels of HDL, or 'good' cholesterol.

Care and treatment, Atherosclerosis, Niacin, Simvastatin

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