title: Preventing angiographic progression of coronary atherosclerosis with pravastatin.
abstract: We conducted a prospective study to investigate the relationship between the decrease of serum lipid levels during pravastatin therapy and changes of coronary angiography parameters in Japanese patients with coronary atherosclerosis. The patients were predominantly male, aged between 18 and 75 years (mean: 58 years), had at least 25% stenosis of one or more major coronary arteries, and had a serum total cholesterol ( TC) level > or = 200 mg/dl (5.18 mM/l). Treatment with pravastatin (10 mg/day) was continued for 3 years. Coronary angiography was performed before and 3 years after the start of pravastatin therapy to assess the relationship between the mean segment diameter (MSD), the minimal lumen diameter (MLD), and the annual changes of percent stenosis and TC levels. of 265 patients who were initially registered, 129 were followed for an average of 35 months. Consequently, second angiograms were only obtained in 68 patients for various reasons, so this group was used for analysis. During pravastatin therapy, the TC level significantly decreased from 239 mg/dl (6.19 mM/l) to 210 mg/dl (5.44 mM/l) (a 12% reduction; p<0.001). In addition, HDL-cholesterol increased by 5% (p=0.007), but the triglyceride level did not show a significant change. Both MSD and MLD were significantly improved on follow-up angiography, increasing from 2.67 mm to 2.76 mm and from 2.09 mm to 2.13 mm, respectively. However, no change of percent stenosis was observed. The mean TC level during treatment did not show any significant correlation with the changes of angiography parameters. However, a significant correlation was observed between the percent reduction of TC and the annual change of MSD (r=-0.272, p=0.027). A similar relationship was also found between the change of MLD and the percent reduction of TC (r=-0.260, p=0.035). In conclusion, the percent decrease of serum cholesterol may be a better indicator of clinical efficacy than the absolute cholesterol level during pravastatin therapy.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan. daida@med.juntendo.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Ouchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Saito
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yamada
authors.forename: Toshio
authors.initials: T
authors.lastname: Nishide
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mokuno
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sato
authors.forename: Masato
authors.initials: M
authors.lastname: Eto
authors.forename: Jun-ya
authors.initials: JY
authors.lastname: Ako
authors.forename: Toshiro
authors.initials: T
authors.lastname: Tango
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamaguchi
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D003331:Coronary Vessels / Q000473:pathology*; D018450:Disease Progression; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000627:therapeutic use*; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D017035:Pravastatin