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Titolo:
EFFECT OF LOVASTATIN ON EARLY CAROTID ATHEROSCLEROSIS AND CARDIOVASCULAR EVENTS
Autore:
FURBERG CD; ADAMS HP; APPLEGATE WB; BYINGTON RP; ESPELAND MA; HARTWELL T; HUNNINGHAKE DB; LEFKOWITZ DS; PROBSTFIELD J; RILEY WA; YOUNG B;
Indirizzi:
WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT PUBL HLTH SCI,300 S HAWTHORNE RD WINSTON SALEM NC 27157 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT NEUROL WINSTON SALEM NC 27157 UNIV IOWA,COLL MED,DEPT NEUROL IOWA CITY IA 00000 UNIV TENNESSEE,DEPT PREVENT MED MEMPHIS TN 00000 RES TRIANGLE INST RES TRIANGLE PK NC 27709 UNIV MINNESOTA MINNEAPOLIS MN 55455 FRED HUTCHINSON CANC RES CTR SEATTLE WA 98104 AUTREC INC WINSTON SALEM NC 00000 UNIV KENTUCKY,MED CTR,DEPT NEUROSURG LEXINGTON KY 40536
Titolo Testata:
Circulation
fascicolo: 4, volume: 90, anno: 1994,
pagine: 1679 - 1687
SICI:
0009-7322(1994)90:4<1679:EOLOEC>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; EXPANDED CLINICAL-EVALUATION; B-MODE ULTRASOUND; ARTERY DISEASE; RISK-FACTORS; REGRESSION; THERAPY; TRIALS; HYPERCHOLESTEROLEMIA; LIPOPROTEINS;
Keywords:
LOVASTATIN; CLINICAL TRIAL; ATHEROSCLEROSIS; CARDIOVASCULAR DISEASES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
40
Recensione:
Indirizzi per estratti:
Citazione:
C.D. Furberg et al., "EFFECT OF LOVASTATIN ON EARLY CAROTID ATHEROSCLEROSIS AND CARDIOVASCULAR EVENTS", Circulation, 90(4), 1994, pp. 1679-1687

Abstract

Background HMG CoA reductase inhibitors (or statins), a new class of lipid-lowering compounds, have raised expectations for more widespreaduse than that of the older lipid-lowering drugs. Not only are they more effective in lowering LDL cholesterol, but they are better tolerated as well. No data exist concerning the effect of statins on early carotid atherosclerosis and clinical events in men and women who have moderately elevated LDL cholesterol levels but are free of symptomatic cardiovascular disease. Methods and Results Lovastatin (20 to 40 mg/d) or its placebo was evaluated in a double-blind, randomized clinical trial with factorial design along with warfarin (1 mg/d) or its placebo. This report is limited to the lovastatin component of the trial. Dailyaspirin (81 mg/d) was recommended for everyone. Enrollment included 919 asymptomatic men and women, 40 to 79 years old, with early carotid atherosclerosis as defined by B-mode ultrasonography and LDL cholesterol between the 60th and 90th percentiles. The 3-year change in mean maximum intimal-medial thickness (IMT) in 12 walls of the carotid arteries was the primary outcome; change in single maximum IMT and incidenceof major cardiovascular events were secondary outcomes. LDL cholesterol fell 28%, from 156.6 mg/dL at baseline to 113.1 mg/dL at 6 months (P < .0001), in the lovastatin groups and was largely unchanged in the lovastatin-placebo groups. Among participants not on warfarin, regression of the mean maximum IMT was seen after 12 months in the lovastatingroup compared with the placebo group; the 3-year difference was statistically significant (P = .001). A larger favorable effect of lovastatin was observed for the change in single maximum IMT but was not statistically significant (P = .12). Five lovastatin-treated participants suffered major cardiovascular events-coronary heart disease mortality,nonfatal myocardial infarction, or stroke - versus 14 in the lovastatin-placebo groups (P = .04). One lovastatin-treated participant died, compared with eight on lovastatin-placebo (P = .02). Conclusions In men and women with moderately elevated LDL cholesterol, lovastatin reverses progression of IMT in the carotid arteries and appears to reduce the risk of major cardiovascular events and mortality. Results from ongoing large-scale clinical trials may further establish the clinical benefit of statins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 16:44:20