Prevention of the angiographic progression of coronary and vein-graft atherosclerosis by gemfibrozil after coronary bypass surgery in men with low levels of HDL cholesterol. Lopid Coronary Angiography Trial (LOCAT) Study Group
Frick MH, Syvänne M, Nieminen MS, Kauma H, Majahalme S, Virtanen V, Kesäniemi YA, Pasternack A, Taskinen MR
Circulation · 236 citas
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Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 1997-10-07 · Circulation · vol. 96 · número 7 · págs. 2137–2143
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 388 citas · más que el 100% de estudios similares · 30.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 44 trabajos
- Acceso
- De pago
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cardiac and Coronary Surgery Techniques · Lipid metabolism and disorders
- Palabras clave
- gemfibrozil, coronary atherosclerosis progression, coronary artery bypass grafting, vein graft atherosclerosis, low HDL cholesterol, LDL cholesterol, hyperlipidemia, triglycerides, coronary angiography, aortocoronary bypass graft, men, statin therapy, coronary artery stenosis, lipid-lowering therapy, secondary prevention of cardiovascular disease, coronary artery disease
- MeSH
- humans, arteriosclerosis, disease progression, graft occlusion, vascular, gemfibrozil, cholesterol, triglycerides, coronary angiography, coronary artery bypass, diet, analysis of variance, time factors, reference values, aged, middle aged, male, cholesterol, ldl, cholesterol, hdl, coronary artery disease, hypolipidemic agents
9 autores
- M. H. Frick🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
- Mikko Syvänne🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
- Markku S. Nieminen🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
- Heikki Kauma🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
- Silja K. Majahalme🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
- Vesa Virtanen🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
- Y. Antero Kesäniemi🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
- Amos I. Pasternack🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
- Marja‐Riitta Taskinen🇫🇮Oulu University Hospital; Helsinki University Hospital; Tampere University Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Studies have shown that treatment of hyperlipidemia, especially lowering of plasma LDL levels, retards the progression of coronary atherosclerosis and prevents clinical cardiovascular events. No such studies have focused on subjects with low levels of HDL cholesterol.
Methods and results
We randomly assigned 395 post-coronary bypass men, who had an HDL cholesterol concentration < or = 1.1 mmol/L and LDL cholesterol < or = 4.5 mmol/L, to receive gemfibrozil 1200 mg/d or placebo. Coronary angiography was performed at baseline and after, on average, 32 months of therapy. Changes in coronary dimensions were assessed by computer-assisted analysis. Average on-trial serum triglyceride concentrations were 1.69+/-0.68 and 1.02+/-0.37, total cholesterol 5.48+/-0.68 and 4.83+/-0.63, LDL cholesterol 3.84+/-0.59 and 3.39+/-0.56, and HDL cholesterol 0.88+/-0.15 and 0.98+/-0.17 mmol/L in the placebo and gemfibrozil groups, respectively (mean+/-SD, each P<.001). The change in per-patient means of average diameters of native coronary segments was -0.04+/-0.11 mm in the placebo group and -0.01+/-0.10 mm in the gemfibrozil group (P=.009). The equivalent changes in minimum luminal diameters of stenoses were -0.09+/-0.18 and -0.04+/-0.15 mm, respectively (P=.002). A similar, albeit nonsignificant, trend toward treatment benefit was found in the predefined primary study end point, segments unaffected by grafts and those distal to graft insertions. In aortocoronary bypass grafts, 23 subjects (14%) assigned to placebo had new lesions in the follow-up angiogram, compared with 4 subjects (2%) assigned to gemfibrozil (P<.001).
Conclusions
Gemfibrozil therapy retarded the progression of coronary atherosclerosis and the formation of bypass-graft lesions after coronary bypass surgery in men with low HDL cholesterol as their main lipid abnormality.
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