Cardiovascular Diseases Clinical Trial
Official title:
Familial Atherosclerosis Treatment Study
To compare the effects of two intensive lipid-lowering regimens with conventional therapy on coronary atherosclerosis as assessed by arteriography.
BACKGROUND:
For several decades, clinical trials have addressed the question of whether treatment of
hyperlipidemia reduces the risk of cardiovascular events. Substantial evidence supports the
idea that cardiovascular benefits are related to the degree of reduction in low-density
lipoprotein cholesterol level and perhaps to the degree of increase in the high-density
lipoprotein cholesterol level. In these trials, changes in lipid levels have usually been
small and the overall clinical benefits have been limited. The appearance in the 1980s of
more effective treatments for hyperlipidemia, new arteriographic methods for assessing
atherosclerosis, and new insights into atherogenesis permitted an objective investigation
into whether the progression of atherosclerosis was retarded or reversed by lipid-lowering
agents.
The clinical trial was supported by a subproject within a program project grant.
DESIGN NARRATIVE:
Randomized, double-blind, placebo-controlled. Baseline arteriograms were performed and
fasting lipid samples drawn before heparinization. Patients were stratified for age below 45
years, cigarette smoking within the previous month, and lipid patterns including familial
hypercholesterolemia and triglyceride levels. Patients were given dietary counseling and
randomly assigned to one of three treatments: lovastatin (20 mg twice a day) and colestipol
(10 g three times a day); niacin (1 g four times a day) and colestipol (10 g three times a
day): or conventional therapy with placebo (or colestipol if the LDL cholesterol level was
elevated). The primary endpoint was a measure of change in the severity of disease in the
proximal coronary arteries as measured by quantitative arteriography.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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