Coronary Artery Disease Clinical Trial
Official title:
A Double-Blind, Placebo-Controlled Angiographic Study to Evaluate the Effect of Lovastatin on the Progression Rate of Atherosclerosis in the Coronary Arteries of Patients With Coronary Heart Disease
The purpose of this study is to determine whether significant alterations in serum lipoproteins as provided by the drug lovastatin can substantially reduce atherosclerosis progression or even induce regression.
Two conceptual advances occurring in the 1980's made it possible to test the hypothesis that
significant alterations in serum lipoproteins can substantially reduce atherosclerosis
progression or even induce regression. The first advance was in the development of
arteriograms used in characterizing atherosclerosis, greatly reducing the number of patients
required for the evaluation of an intervention designed to prevent coronary atherosclerosis
progression. The second advance was the development of lovastatin that provides a
lipid-lowering alternative much easier to tolerate than the niacin/colestipol combination
previously used, and has been shown to be comparably effective for LDL reduction in patients
with a family history of high cholesterol.
A total of 270 high-risk coronary artery disease patients, not eligible for coronary artery
bypass surgery, were recruited for the study. All patients received angiograms and were
randomly assigned to either the lovastatin or placebo groups stratified by three baseline
factors: sex, smoking status, and plasma cholesterol levels.
Patients initially received lovastatin 40mg twice a day or a matching placebo. Those
patients receiving lovastatin whose total plasma cholesterol level was less than 110mg/dL at
one visit or 120 mg/dL on two successive visits had their dosage halved, and were maintained
on the optimal dosage for the remainder of the study. Coronary angiography was performed
prior to screening and at month 24 (visit 18). Angiographic assessment of both femoral
arteries was also performed at baseline and at month 24. Noninvasive ultrasound imaging of
the carotid arteries (including carotid intima-media thickness) was performed every 6
months. Patients reported to the clinic monthly for 12 months, and at two-month intervals
thereafter. Plasma lipids, routine laboratory safety and physical examinations were also
performed.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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