PMID- 7934538
OWN - NLM
STAT- MEDLINE
DCOM- 19941116
LR  - 20190611
IS  - 0140-6736 (Print)
IS  - 0140-6736 (Linking)
VI  - 344
IP  - 8931
DP  - 1994 Oct 29
TI  - Effect on coronary atherosclerosis of decrease in plasma cholesterol 
      concentrations in normocholesterolaemic patients. Harvard Atherosclerosis 
      Reversibility Project (HARP) Group.
PG  - 1182-6
AB  - Lipid-lowering therapy ameliorates coronary atherosclerosis in patients with 
      raised concentrations of low-density-lipoprotein (LDL) cholesterol. We have 
      investigated whether a similar benefit can be obtained in normocholesterolaemic 
      patients. We studied 79 normocholesterolaemic patients with coronary heart 
      disease (70 male, 9 female), mean age 58 years, all non-smokers, with mean total 
      cholesterol concentration 5.5 mmol/L. All patients received diet therapy and were 
      randomly assigned placebo (39) or active treatment (40) with pravastatin, 
      nicotinic acid, cholestyramine, and gemfibrozil stepwise as needed to reach the 
      specified goal (total cholesterol < or = 4.1 mmol/L, ratio of 
      LDL/high-density-lipoprotein [HDL] cholesterol < or = 2.0). Coronary angiograms 
      at baseline and after 2.5 years of treatment were analysed by computer-assisted 
      quantitative techniques. There was no significant difference in coronary 
      atherosclerosis during follow-up between the active treatment and placebo groups; 
      the mean minimum diameter narrowed significantly but to the same extent in both 
      groups (change baseline to 2.5 years 0.14 [SD 0.42] and 0.15 [0.42] mm, 
      respectively, both p < 0.001). Similarly, the change in percentage stenosis did 
      not differ between the groups (2.1 [10.6] vs 2.4 [10.3]%). By multiple regression 
      analysis, the adjusted difference between the groups was a 0.04 mm (95% CI -0.04 
      to 0.12 mm) increase in minimum diameter and a 0% (-1.7 to 1.7) change in 
      percentage stenosis. The groups differed significantly in plasma lipids (% change 
      in active minus % change in placebo group: -28% total cholesterol, -41% 
      LDL-cholesterol, 13% HDL-cholesterol, -26% triglycerides, -31% apolipoprotein B, 
      all p < 0.001). Thus, intensive pharmacological treatment of 
      normocholesterolaemic patients has significant effects on plasma lipid 
      concentrations but no angiographically measurable benefit on the coronary 
      arteries.
FAU - Sacks, F M
AU  - Sacks FM
AD  - Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
FAU - Pasternak, R C
AU  - Pasternak RC
FAU - Gibson, C M
AU  - Gibson CM
FAU - Rosner, B
AU  - Rosner B
FAU - Stone, P H
AU  - Stone PH
LA  - eng
GR  - MOI RR02635/RR/NCRR NIH HHS/United States
GR  - R0I HL36392/HL/NHLBI NIH HHS/United States
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - Lancet
JT  - Lancet (London, England)
JID - 2985213R
RN  - 0 (Anticholesteremic Agents)
RN  - 0 (Cholesterol, HDL)
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Lipids)
RN  - 11041-12-6 (Cholestyramine Resin)
RN  - 2679MF687A (Niacin)
RN  - 97C5T2UQ7J (Cholesterol)
RN  - KXO2KT9N0G (Pravastatin)
RN  - Q8X02027X3 (Gemfibrozil)
SB  - IM
CIN - Lancet. 1994 Dec 24-31;344(8939-8940):1767; author reply 1767-8. PMID: 7997016
MH  - Anticholesteremic Agents/*therapeutic use
MH  - Cardiac Catheterization
MH  - Cholesterol/*blood
MH  - Cholesterol, HDL/blood
MH  - Cholesterol, LDL/blood
MH  - Cholestyramine Resin/therapeutic use
MH  - Coronary Angiography
MH  - Coronary Artery Disease/*blood/diagnostic imaging/diet therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Gemfibrozil/therapeutic use
MH  - Humans
MH  - Lipids/*blood
MH  - Male
MH  - Middle Aged
MH  - Niacin/therapeutic use
MH  - Pravastatin/therapeutic use
MH  - Treatment Outcome
EDAT- 1994/10/29 00:00
MHDA- 1994/10/29 00:01
CRDT- 1994/10/29 00:00
PHST- 1994/10/29 00:00 [pubmed]
PHST- 1994/10/29 00:01 [medline]
PHST- 1994/10/29 00:00 [entrez]
AID - S0140-6736(94)90506-1 [pii]
AID - 10.1016/s0140-6736(94)90506-1 [doi]
PST - ppublish
SO  - Lancet. 1994 Oct 29;344(8931):1182-6. doi: 10.1016/s0140-6736(94)90506-1.