PMID- 7572692
OWN - NLM
STAT- MEDLINE
DCOM- 19951027
LR  - 20190622
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 76
IP  - 9
DP  - 1995 Sep 28
TI  - The influence of pretreatment low density lipoprotein cholesterol concentrations 
      on the effect of hypocholesterolemic therapy on coronary atherosclerosis in 
      angiographic trials. Harvard Atherosclerosis Reversibility Project Research 
      Group.
PG  - 78C-85C
AB  - Angiographic trials of coronary atherosclerosis treatment have demonstrated that 
      lowering low density lipoprotein (LDL) cholesterol concentrations improves 
      coronary artery stenosis. Most patients in previous trials have had at least 
      mildly elevated LDL. Recently, however, the Harvard Atherosclerosis Reversibility 
      Project (HARP) did not find such benefit in patients with lower baseline LDL 
      levels compared with previous trials. We reviewed and analyzed all 
      cholesterol-lowering trials that used angiographic endpoints. Unifactorial trials 
      of hypocholesterolemic dietary or drug therapy demonstrated that the higher the 
      baseline LDL, the greater the improvement in quantitatively determined stenosis 
      in the treatment group compared with the controls (r = .83). Considering the 
      change in stenosis in the treatment group alone, regression was more common in 
      trials in which baseline mean LDL was > 170 mg/dl (> 4.4 mmol/liter), whereas 
      progression occurred when baseline mean LDL was < 170 mg/dl (< 4.4 mmol/liter). 
      HARP had the lowest baseline LDL (137 mg/dl [3.54 mmol/liter]), and showed no 
      tendency for improvement in lesions. In contrast to the influence of baseline LDL 
      levels, neither a low LDL level achieved on treatment nor a large percentage 
      reduction in LDL was related to improvement in lesions. Sample size differences 
      between HARP and the other trials are unlikely to be a major explanatory factor, 
      since trials of comparable sample size to HARP, but with higher initial LDL, 
      demonstrated favorable results. We conclude that coronary lesions that develop in 
      the context of average LDL levels show less angiographic improvement in response 
      to substantial LDL reduction than lesions in hypercholesterolemic 
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Sacks, F M
AU  - Sacks FM
AD  - Channing Laboratory, Brigham and Women's Hospital, Beth Israel Hospital, Boston, 
      Massachusetts, USA.
FAU - Gibson, C M
AU  - Gibson CM
FAU - Rosner, B
AU  - Rosner B
FAU - Pasternak, R C
AU  - Pasternak RC
FAU - Stone, P H
AU  - Stone PH
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anticholesteremic Agents)
RN  - 0 (Cholesterol, LDL)
SB  - IM
MH  - Adult
MH  - Anticholesteremic Agents/*therapeutic use
MH  - Cholesterol, LDL/*blood
MH  - Constriction, Pathologic
MH  - Coronary Angiography
MH  - Coronary Artery Disease/*blood/diagnostic imaging/drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Randomized Controlled Trials as Topic
RF  - 30
EDAT- 1995/09/28 00:00
MHDA- 1995/09/28 00:01
CRDT- 1995/09/28 00:00
PHST- 1995/09/28 00:00 [pubmed]
PHST- 1995/09/28 00:01 [medline]
PHST- 1995/09/28 00:00 [entrez]
AID - S0002-9149(99)80475-5 [pii]
AID - 10.1016/s0002-9149(99)80475-5 [doi]
PST - ppublish
SO  - Am J Cardiol. 1995 Sep 28;76(9):78C-85C. doi: 10.1016/s0002-9149(99)80475-5.