Effects of probucol and pravastatin on common carotid atherosclerosis in patients with asymptomatic hypercholesterolemia. Fukuoka Atherosclerosis Trial (FAST).
OBJECTIVE
This study investigated the effect of reducing serum lipids on carotid artery intima-media thickness (IMT) in asymptomatic patients with hypercholesterolemia from Fukuoka, Japan.


BACKGROUND
Carotid atherosclerosis is a strong, independent predictor of morbidity and mortality in patients with coronary heart disease (CHD).


METHODS
A total of 246 asymptomatic hypercholesterolemic patients (mean age 66 years) were randomized to receive either probucol (500 mg/day, n = 82) or pravastatin (10 mg/day, n = 83) or to enter a control group (diet alone, n = 81); they were followed for two years. The change in IMT in the common carotid artery was the primary end point measure, and the incidence of major cardiovascular events was the secondary measure.


RESULTS
Over the two-year period, serum low-density lipoprotein (LDL) cholesterol was significantly reduced in the pravastatin group (36%), the probucol group (29%) and the control group (12%) (p < 0.0001, p < 0.0001 and p < 0.05, respectively). After two years, the probucol and pravastatin groups showed a significant reduction in IMT (-13.9% and -13.9% and p < 0.01 and p < 0.01, respectively), but there was significant IMT thickening (23.2%; p < 0.05) in the control group. Probucol reduced the rate of IMT increase, independently of its reduction of LDL or high-density lipoprotein cholesterol. Moreover, there was a significantly lower incidence of cardiac events in the probucol group (2.4%) than in the control group (13.6%) (p = 0.0136).


CONCLUSIONS
Probucol reduced cholesterol levels and stabilized plaque, leading to a lower incidence of cardiac events in these hypercholesterolemic patients.
Sawayama
Yasunori
Y
Department of General Medicine l, Kyushu University Hospital, Fukuoka, Japan.
Shimizu
Chie
C
Maeda
Naoyasu
N
Tatsukawa
Masafumi
M
Kinukawa
Naoko
N
Koyanagi
Samon
S
Kashiwagi
Seizaburo
S
Hayashi
Jun
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000517:prevention & control*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000187:drug effects*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D007564:Japan; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000627:therapeutic use*; D011341:Probucol / Q000627:therapeutic use*; D012074:Remission Induction; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000187:drug effects*; D014463:Ultrasonography
D000924:Anticholesteremic Agents; D008074:Lipoproteins; D017035:Pravastatin; D011341:Probucol