Stroke, Vol 24, 1779-1783, Copyright © 1993 by American Heart Association
WJ Mack, RH Selzer, HN Hodis, JK Erickson, CR Liu, CH Liu, DW Crawford and DH Blankenhorn
BACKGROUND AND PURPOSE: The Cholesterol Lowering Atherosclerosis Study has
reported significant reduction of coronary artery disease and of carotid
arterial intima-media thickness (IMT) at 2 and 4 years with
colestipol/niacin therapy. We now report on treatment effects on carotid
IMT at 6 months and 1 year. METHODS: One hundred eighty-eight nonsmoking
men, aged 40 to 59 years, with prior coronary artery bypass graft surgery
were randomized to colestipol/niacin plus diet therapy or placebo plus diet
therapy. Computerized image processing of carotid ultrasound films was used
to measure IMT in the right common carotid artery. Treatment group
comparisons were made at 6 months and 1 year (46 and 33 subjects,
respectively, with baseline and 6-month or 1-year ultrasound measures). The
time course of the treatment effect on carotid IMT was estimated using the
complete sample of 78 subjects with baseline and on-trial data. RESULTS: No
significant treatment group differences on carotid IMT were found at 6
months. At 1 year, the treated group showed significant reduction of
carotid IMT (P = .01 between groups). The placebo group showed continuing
progression of IMT during the 4-year study period (estimated progression
rate, 0.018 mm/y). The treated group showed reduction of IMT during the
first 3 years and a plateau during the remainder of the study. CONCLUSIONS:
Reduction of carotid IMT was found with aggressive lipid-lowering therapy.
Ultrasound measures of IMT offer a noninvasive and precise measure of early
carotid atherosclerosis that will decrease sample size requirements,
potentially decrease dropout rates, and widen the study population of
antiatherosclerotic clinical trials.
ARTICLES
One-year reduction and longitudinal analysis of carotid intima-media thickness associated with colestipol/niacin therapy
Department of Preventive Medicine, University of Southern California, Los Angeles 90033.
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