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  1. Article: Coronary Disease Survival with Diabetes

    Hamilton, Dale J. / Gotto Jr., Antonio M.

    Cardiology

    2017  Volume 139, Issue 1, Page(s) 40–42

    Institution Houston Methodist Research Institute, and Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Houston Methodist Hospital, Houston, TX, and Weill Cornell Medicine, New York, NY, USA
    Language English
    Publishing date 2017-12-09
    Publisher S. Karger AG
    Publishing place Basel, Switzerland
    Document type Article
    Note Editorial Comment
    ZDB-ID 80092-2
    ISSN 1421-9751 ; 0008-6312
    ISSN (online) 1421-9751
    ISSN 0008-6312
    DOI 10.1159/000484518
    Database Karger publisher's database

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  2. Article ; Online: Lipid-Lowering Trials: What Have They Taught Us about Morbidity and Mortality?

    Gotto, Jr., Antonio M.

    Cardiology - International Journal of Cardiovascular Medicine, Surgery, Pathology and Pharmacology

    1996  Volume 87, Issue 6, Page(s) 453–457

    Abstract: An abundance of clinical trial data indicates that lipid-regulating therapy reduces coronary artery disease morbidity and mortality. In patients with established coronary artery disease, lipid regulation has been shown to attenuate progression of ... ...

    Abstract An abundance of clinical trial data indicates that lipid-regulating therapy reduces coronary artery disease morbidity and mortality. In patients with established coronary artery disease, lipid regulation has been shown to attenuate progression of atherosclerosis and extend survival. In primary prevention, a clear benefit of therapy on survival has not been demonstrated, leading some to question its value. However, the probability of false negatives for total mortality in primary-prevention trials is high, and the potential benefit of primary-prevention measures to public health is great. Additional investigations should further clarify the role of lipid-regulating therapy, particularly in important populations for whom fewer data are available, such as women and the elderly.
    Keywords Coronary artery disease ; Clinical trials ; Atherosclerosis ; Risk factors ; Lipoproteins
    Language English
    Publisher S. Karger AG
    Publishing place Basel
    Publishing country Switzerland
    Document type Article ; Online
    ZDB-ID 80092-2
    ISSN 1421-9751 ; 0008-6312 ; 0008-6312
    ISSN (online) 1421-9751
    ISSN 0008-6312
    DOI 10.1159/000177138
    Database Karger publisher's database

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  3. Article ; Online: Long-term cardiovascular risks and the impact of statin treatment on socioeconomic inequalities: a microsimulation model.

    Wu, Runguo / Williams, Claire / Zhou, Junwen / Schlackow, Iryna / Emberson, Jonathan / Reith, Christina / Keech, Anthony / Robson, John / Armitage, Jane / Gray, Alastair / Simes, John / Baigent, Colin / Mihaylova, Borislava / Barnes, Elizabeth / Blackwell, Lisa / Collins, Rory / Davies, Kelly / Fulcher, Jordan / Halls, Heather /
    Herrington, William G / Holland, Lisa / Kirby, Adrienne / O'Connell, Rachel / Preiss, David / Wilson, Kate / Blazing, Michael / Braunwald, Eugene / Lemos, James de / Murphy, Sabina / Pedersen, Terje R / Pfeffer, Marc / White, Harvey / Wiviott, Stephen / Clearfield, Michael / Downs, John R / Gotto, Antonio / Weis, Stephen / Fellström, Bengt / Holdaas, Hallvard / Jardine, Alan / Gordon, David / Davis, Barry / Furberg, Curt / Grimm, Richard / Pressel, Sara / Probstfield, Jeffrey L / Rahman, Mahboob / Simpson, Lara / Koren, Michael / Dahlöf, Björn / Gupta, Ajay / Poulter, Neil / Sever, Peter / Wedel, Hans / Knopp, Robert H / Cobbe, Stuart / Schmieder, Roland / Zannad, Faiez / Betteridge, D John / Colhoun, Helen M / Durrington, Paul N / Fuller, John / Hitman, Graham A / Neil, Andrew / Hawkins, C Morton / Moyé, Lemuel / Sacks, Frank / Kjekshus, John / Wikstrand, John / Wanner, Christoph / Krane, Vera / Franzosi, Maria Grazia / Latini, Roberto / Lucci, Donata / Maggioni, Aldo / Marchioli, Roberto / Nicolis, Enrico B / Tavazzi, Luigi / Tognoni, Gianni / Bosch, Jackie / Lonn, Eva / Yusuf, Salim / Bowman, Louise / Landray, Martin / Parish, Sarah / Peto, Richard / Sleight, Peter / Kastelein, John Jp / Glynn, Robert / Gotto, Antonio / Koenig, Wolfgang / MacFadyen, Jean / Ridker, Paul M / MacMahon, Stephen / Marschner, Ian / Tonkin, Andrew / Shaw, John / Serruys, Patrick W / Knatterud, Genell / Blauw, Gerard J / Ford, Ian / Macfarlane, Peter / Packard, Chris / Sattar, Naveed / Shepherd, James / Trompet, Stella / Cannon, Christopher P / Bulbulia, Richard / Haynes, Richard / Amarenco, Pierre / Welch, K Michael / Wilhelmsen, Lars / Barter, Philip / LaRosa, John / Kean, Sharon / Roberston, Michele / Young, Robin / Arashi, Hiroyuki / Clarke, Robert / Flather, Marcus / Goto, Shinya / Goldbourt, Uri / Hopewell, Jemma / Hovingh, G Kees / Kitas, George / Newman, Connie / Sabatine, Marc S / Schwartz, Gregory G / Smeeth, Liam / Tobert, Jonathan / Varigos, John / Yamamguchi, Junichi

    The British journal of general practice : the journal of the Royal College of General Practitioners

    2024  

    Abstract: Background: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist.: Aim: To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin ... ...

    Abstract Background: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist.
    Aim: To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin treatment across quintiles of socioeconomic deprivation in the UK.
    Design and setting: A lifetime microsimulation model was developed using 117 896 participants in 16 statin trials, 501 854 UK Biobank (UKB) participants, and quality-of-life data from national health surveys.
    Method: A CVD microsimulation model was developed using risk equations for myocardial infarction, stroke, coronary revascularisation, cancer, and vascular and non-vascular death, estimated using trial data. The authors calibrated and further developed this model in the UKB cohort, including further characteristics and a diabetes risk equation, and validated the model in UKB and Whitehall II cohorts. The model was used to predict CVD incidence, life expectancy, quality-adjusted life years (QALYs), and the impact of UK guideline-recommended statin treatment across socioeconomic deprivation quintiles.
    Results: Age, sex, socioeconomic deprivation, smoking, hypertension, diabetes, and cardiovascular events were key CVD risk determinants. Model-predicted event rates corresponded well to observed rates across participant categories. The model projected strong gradients in remaining life expectancy, with 4-5-year (5-8 QALYs) gaps between the least and most socioeconomically deprived quintiles. Guideline-recommended statin treatment was projected to increase QALYs, with larger gains in quintiles of higher deprivation.
    Conclusion: The study demonstrated the potential of guideline-recommended statin treatment to reduce socioeconomic inequalities. This CVD model is a novel resource for individualised long-term projections of health outcomes of CVD treatments.
    Language English
    Publishing date 2024-02-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 1043148-2
    ISSN 1478-5242 ; 0035-8797 ; 0960-1643
    ISSN (online) 1478-5242
    ISSN 0035-8797 ; 0960-1643
    DOI 10.3399/BJGP.2023.0198
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Effects of SREBF-1a and SCAP polymorphisms on plasma levels of lipids, severity, progression and regression of coronary atherosclerosis and response to therapy with fluvastatin.

    Salek, Lorraine / Lutucuta, Silvia / Ballantyne, Christie M / Gotto Jr, Antonio M / Marian, A J

    Journal of molecular medicine (Berlin, Germany)

    2002  Volume 80, Issue 11, Page(s) 737–744

    Abstract: Sterol regulatory elements binding factor-1a (SREBF-1a) and SREBF cleavage activating protein (SCAP) regulate lipids homeostasis. Polymorphisms in SREBF-1a and SCAP could affect plasma levels of lipids and risk of atherosclerosis. We determined ... ...

    Abstract Sterol regulatory elements binding factor-1a (SREBF-1a) and SREBF cleavage activating protein (SCAP) regulate lipids homeostasis. Polymorphisms in SREBF-1a and SCAP could affect plasma levels of lipids and risk of atherosclerosis. We determined association of SREBF-1a -36del/G and SCAP 2386A/G genotypes with plasma levels of lipids, severity and progression/regression of coronary atherosclerosis, and response to treatment with fluvastatin in a well-characterized Lipoprotein Coronary Atherosclerosis Study population. Plasma lipids and quantitative indices of coronary atherosclerosis were obtained at baseline and 2.5 years following randomization to fluvastatin or placebo in 372 subjects. Fluvastatin reduced plasma levels of total cholesterol by 16%, LDL-C by 25%, and ApoB by 16% and increased plasma levels of HDL-C by 9% and apoA-1 by 7%. Distributions of SREBF-1a SCAP genotypes were 60 GG, 172 del-G and 140 del-del and 88 GG, 188 GA and 96 AA, respectively. There were no significant differences in baseline plasma levels of lipids or indices of severity of atherosclerosis among the genotypes of each gene. There was a strong graded genotype-treatment interaction between SREBF-1a genotypes and change in apoA-I levels in response to fluvastatin (16.5% increase in GG, 10.5% in del/G, and 0.4% in del/del groups). Modest interactions between SREBF-1a genotypes and changes in HDL-C, and apoC-III levels in response to fluvastatin were also present. No genotype-treatment interaction for progression or regression of coronary atherosclerosis was detected. There were no significant interactions between SCAP genotypes and response to therapy. Thus we detected a strong graded interaction between SREBF-1a -36del/G genotypes and response of plasma apoA-I to treatment with fluvastatin.
    MeSH term(s) Anticholesteremic Agents/pharmacokinetics ; Anticholesteremic Agents/therapeutic use ; Apolipoprotein A-I/blood ; CCAAT-Enhancer-Binding Proteins/genetics ; Coronary Artery Disease/blood ; Coronary Artery Disease/drug therapy ; Coronary Artery Disease/genetics ; DNA-Binding Proteins/genetics ; Disease Progression ; Fatty Acids, Monounsaturated/pharmacokinetics ; Fatty Acids, Monounsaturated/therapeutic use ; Genotype ; Humans ; Indoles/pharmacokinetics ; Indoles/therapeutic use ; Intracellular Signaling Peptides and Proteins ; Lipids/blood ; Membrane Proteins/genetics ; Polymorphism, Genetic ; Sterol Regulatory Element Binding Protein 1 ; Transcription Factors
    Chemical Substances Anticholesteremic Agents ; Apolipoprotein A-I ; CCAAT-Enhancer-Binding Proteins ; DNA-Binding Proteins ; Fatty Acids, Monounsaturated ; Indoles ; Intracellular Signaling Peptides and Proteins ; Lipids ; Membrane Proteins ; SREBF1 protein, human ; SREBP cleavage-activating protein ; Sterol Regulatory Element Binding Protein 1 ; Transcription Factors ; fluvastatin (4L066368AS)
    Language English
    Publishing date 2002-11
    Publishing country Germany
    Document type Clinical Trial ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1223802-8
    ISSN 1432-1440 ; 0946-2716
    ISSN (online) 1432-1440
    ISSN 0946-2716
    DOI 10.1007/s00109-002-0381-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Genetic Deletion of Low Density Lipoprotein Receptor Impairs Sterol-induced Mouse Macrophage ABCA1 Expression: A NEW SREBP1-DEPENDENT MECHANISM

    Zhou, Xiaoye / He, Wei / Huang, Zhiping / Gotto, Antonio M. Jr / Hajjar, David P / Han, Jihong

    Journal of biological chemistry. 2008 Jan. 25, v. 283, no. 4

    2008  

    Abstract: Low density lipoprotein receptor (LDLR) mutations cause familial hypercholesterolemia and early atherosclerosis. ABCA1 facilitates free cholesterol efflux from peripheral tissues. We investigated the effects of LDLR deletion (LDLR⁻/⁻) on ABCA1 expression. ...

    Abstract Low density lipoprotein receptor (LDLR) mutations cause familial hypercholesterolemia and early atherosclerosis. ABCA1 facilitates free cholesterol efflux from peripheral tissues. We investigated the effects of LDLR deletion (LDLR⁻/⁻) on ABCA1 expression. LDLR⁻/⁻ macrophages had reduced basal levels of ABCA1, ABCG1, and cholesterol efflux. A high fat diet increased cholesterol in LDLR⁻/⁻ macrophages but not wild type cells. A liver X receptor (LXR) agonist induced expression of ABCA1, ABCG1, and cholesterol efflux in both LDLR⁻/⁻ and wild type macrophages, whereas expression of LXRα or LXRβ was similar. Interestingly, oxidized LDL induced more ABCA1 in wild type macrophages than LDLR⁻/⁻ cells. LDL induced ABCA1 expression in wild type cells but inhibited it in LDLR⁻/⁻ macrophages in a concentration-dependent manner. However, lipoproteins regulated ABCG1 expression similarly in LDLR⁻/⁻ and wild type macrophages. Cholesterol or oxysterols induced ABCA1 expression in wild type macrophages but had little or inhibitory effects on ABCA1 expression in LDLR⁻/⁻ macrophages. Active sterol regulatory element-binding protein 1a (SREBP1a) inhibited ABCA1 promoter activity in an LXRE-dependent manner and decreased both macrophage ABCA1 expression and cholesterol efflux. Expression of ABCA1 in animal tissues was inversely correlated to active SREBP1. Oxysterols inactivated SREBP1 in wild type macrophages but not in LDLR⁻/⁻ cells. Oxysterol synergized with nonsteroid LXR ligand induced ABCA1 expression in wild type macrophages but blocked induction in LDLR⁻/⁻ cells. Taken together, our studies suggest that LDLR is critical in the regulation of cholesterol efflux and ABCA1 expression in macrophage. Lack of the LDLR impairs sterol-induced macrophage ABCA1 expression by a sterol regulatory element-binding protein 1-dependent mechanism that can result in reduced cholesterol efflux and lipid accumulation in macrophages under hypercholesterolemic conditions.
    Language English
    Dates of publication 2008-0125
    Size p. 2129-2138.
    Publishing place American Society for Biochemistry and Molecular Biology
    Document type Article
    ZDB-ID 2997-x
    ISSN 1083-351X ; 0021-9258
    ISSN (online) 1083-351X
    ISSN 0021-9258
    Database NAL-Catalogue (AGRICOLA)

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  6. Article ; Online: Plasma lipids and other cardiovascular risk factors in Costa Rican adolescents Lípidos plasmáticos y otros factores de riesgo cardiovascular en adolescentes costarricenses

    Michael S. Irwig / Xinia Siles / Antonio M. Gotto, Jr. / Nader Rifai / Hannia Campos

    Revista Panamericana de Salud Pública, Vol 8, Iss 4, Pp 234-

    2000  Volume 241

    Abstract: This study assessed plasma lipids and other cardiovascular risk factors in adolescents in a developing Latin American country and compared those risk factors to those of adolescents in the United States of America, where the risk of heart disease is high. ...

    Abstract This study assessed plasma lipids and other cardiovascular risk factors in adolescents in a developing Latin American country and compared those risk factors to those of adolescents in the United States of America, where the risk of heart disease is high. In a cross-sectional study, data were collected from September 1998 to April 1999 on 161 Costa Rican adolescents between the ages of 12 and 20. A general questionnaire was used to collect demographic, smoking, socioeconomic, and women's health data. Anthropometric measurements, blood pressure, and a fasting blood sample were taken. The Costa Rican males had lower levels of total cholesterol than did the Costa Rican females (mean ± standard error of the mean (SEM), 149 ± 6.5 mg/dL vs. 158 ± 6.3 mg/dL). This was mainly due to lower high-density lipoprotein (HDL) cholesterol in males than in females (mean ± SEM, 38 ± 2.0 mg/dL vs. 44 ± 2.4 mg/dL). As compared to the United States, adolescents in this study had lower levels of total cholesterol, largely due to lower HDL cholesterol. Both genders of Costa Ricans had levels of low-density lipoprotein (LDL) cholesterol that were similar to those of counterpart groups in the United States. Costa Rican male and female adolescents had higher LDL/HDL ratios than did their United States counterparts. Therefore, as compared to the United States, Costa Rican adolescents have an adverse lipid profile as demonstrated by a higher LDL/HDL ratio. Overweight prevalence in Costa Rica was 13%, approaching the 15% overall level of the United States. En este estudio se investigaron los lípidos plasmáticos y otros factores de riesgo cardiovascular en adolescentes de un país latinoamericano en desarrollo y se compararon con los factores de riesgo de los adolescentes de los Estados Unidos de América (EUA), en los que el riesgo de cardiopatía es alto. El estudio, de tipo transversal, se realizó entre septiembre de 1998 y abril de 1999, y recogió datos de 161 adolescentes costarricences de 12 a 20 años de edad. Mediante un cuestionario general se registró la información demográfica, socioeconómica, obstétrico-ginecológica y sobre el consumo de tabaco. Se efectuaron mediciones antropométricas, se registró la tensión arterial y se obtuvieron muestras de sangre en ayunas. Los varones costarricenses tenían concentraciones totales de colesterol inferiores a las de las mujeres costarricenses (media ± error estándar de la media (EEM) 149 ± 6,5 mg/dL frente a 158 ± 6,3 mg/dL). Esto se debió, sobre todo, a las menores concentraciones de colesterol de las lipoproteínas de alta densidad (HDL) en los hombres que en las mujeres (media ± EEM, 38 ± 2,0 mg/dL frente a 44 ± 2,4 mg/dL). En comparación con los adolescentes de los EUA, los de Costa Rica tenían menores niveles de colesterol total, debido sobre todo al colesterol de las HDL. Los costarricenses de ambos sexos tenían concentraciones de colesterol de las lipoproteínas de baja densidad (LDL) similares a las de los grupos correspondientes en los EUA y mayores razones LDL/HDL. Por tanto, en comparación con los adolescentes de los EUA, los costarricenses tenían un perfil lipídico adverso, como demuestra la mayor razón LDL/HDL. La prevalencia del sobrepeso en Costa Rica fue del 13%, cercana al 15% global de los EUA.
    Keywords Medicine ; R ; Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2000-10-01T00:00:00Z
    Publisher Pan American Health Organization
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article: Diet and heart disease: responses to the findings concluded lrc-cppt

    Gotto, Antonio M., Jr

    Nutrition today. 1984 , v. 19, no. 6

    1984  

    Abstract: In January of this year, the Heart, Lung and Blood Institute of the National Institutes of Health released the results of its study which was designed to measure the effect of the drug, cholestyramine, on the incidence of coronary heart disease and on ... ...

    Abstract In January of this year, the Heart, Lung and Blood Institute of the National Institutes of Health released the results of its study which was designed to measure the effect of the drug, cholestyramine, on the incidence of coronary heart disease and on mortality rates of those suffering that affliction.The drug usedin the 71/2-year study is a synthetic resin which is said to have an affinity for dietary cholesterol. The investigators hoped to exploit this characteristic, hoped that it would reduce serum cholesterol in a group of men selected for their elevated blood cholesterol levels.On January 20, 1984 the final scientific report was published in the Journal of the American Medical Association. The results were reported in mathematical terms, viz, “For each one percent fall in cholesterol level, a 2% reduction, a heart attack risk can be expected.”Nutrition Today published the original transcript of the findings and at the same time editorially expressed our opinion that the claims made to the public were not substantiated by the report.We, therefore, invited 27 health scientists well informed in medicine, dietetics and nutrition biochemistry to comment on the health institute report. In the last issue of the magazine, we published 12 responses and with the following responses, we conclude those who responded to our invitation to comment on the study and report.
    Keywords blood serum ; cholesterol ; cholestyramine ; coronary disease ; diet ; dietetics ; heart ; medicine ; men ; mortality ; myocardial infarction ; nutrition risk assessment
    Language English
    Dates of publication 1984-11
    Size p. 20-25.
    Publishing place Williams & Wilkins
    Document type Article
    Note Affiliations: Dr. Gotto is president of the American Heart Association, a professor, Department of Medicine, Baylor College of Medicine and a professor, Methodist Hospital, Baylor, Texas 77030.
    ZDB-ID 2053548-X
    ISSN 1538-9839 ; 0029-666X
    ISSN (online) 1538-9839
    ISSN 0029-666X
    Database NAL-Catalogue (AGRICOLA)

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  8. Article ; Online: Plasma lipids and other cardiovascular risk factors in Costa Rican adolescents

    Irwig Michael S. / Siles Xinia / Gotto Jr., Antonio M. / Rifai Nader / Campos Hannia

    Revista Panamericana de Salud Pública, Vol 8, Iss 4, Pp 234-

    2000  Volume 241

    Abstract: This study assessed plasma lipids and other cardiovascular risk factors in adolescents in a developing Latin American country and compared those risk factors to those of adolescents in the United States of America, where the risk of heart disease is high. ...

    Abstract This study assessed plasma lipids and other cardiovascular risk factors in adolescents in a developing Latin American country and compared those risk factors to those of adolescents in the United States of America, where the risk of heart disease is high. In a cross-sectional study, data were collected from September 1998 to April 1999 on 161 Costa Rican adolescents between the ages of 12 and 20. A general questionnaire was used to collect demographic, smoking, socioeconomic, and women's health data. Anthropometric measurements, blood pressure, and a fasting blood sample were taken. The Costa Rican males had lower levels of total cholesterol than did the Costa Rican females (mean ± standard error of the mean (SEM), 149 ± 6.5 mg/dL vs. 158 ± 6.3 mg/dL). This was mainly due to lower high-density lipoprotein (HDL) cholesterol in males than in females (mean ± SEM, 38 ± 2.0 mg/dL vs. 44 ± 2.4 mg/dL). As compared to the United States, adolescents in this study had lower levels of total cholesterol, largely due to lower HDL cholesterol. Both genders of Costa Ricans had levels of low-density lipoprotein (LDL) cholesterol that were similar to those of counterpart groups in the United States. Costa Rican male and female adolescents had higher LDL/HDL ratios than did their United States counterparts. Therefore, as compared to the United States, Costa Rican adolescents have an adverse lipid profile as demonstrated by a higher LDL/HDL ratio. Overweight prevalence in Costa Rica was 13%, approaching the 15% overall level of the United States.
    Keywords Public aspects of medicine ; RA1-1270 ; Medicine ; R ; DOAJ:Public Health ; DOAJ:Health Sciences
    Subject code 320
    Language English
    Publishing date 2000-01-01T00:00:00Z
    Publisher Organización Panamericana de la Salud
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article: [No title information]

    Gotto, A. M.

    JAMA. J. American Medical Association

    1998  Volume 279, Issue 20, Page(s) 1615–1622

    Abstract: Context: Although cholesterol-reducing treatment has been shown to reduce fatal and nonfatal coronary disease in patients with coronary heart disease (CHD), it is unknown whether benefit from the reduction of low-density lipoprotein cholesterol (LDL-C) ... ...

    Institution 1300 York Ave, Room F105, USA-New York, NY 10021 c/o Antonio M. Gotto Jr., Cornell University Medical College
    Abstract Context: Although cholesterol-reducing treatment has been shown to reduce fatal and nonfatal coronary disease in patients with coronary heart disease (CHD), it is unknown whether benefit from the reduction of low-density lipoprotein cholesterol (LDL-C) in patients without CHD extends to individuals with average serum cholesterol levels, women, and older persons. Objective: To compare lovastatin with placebo for prevention of the first acute major coronary event in men and women without clinically evident atherosclerotic cardiovascular disease with average total cholesterol (TC) and LDL-C levels and below-average high-density lipoprotein cholesterol (HDL-C) levels. Design: A randomized, double-blind, placebo-controlled trial. Setting: Outpatient clinics in Texas. Participants: A total of 5608 men and 997 women with average TC and LDL-C and below-average HDL-C (as characterized by lipid percentiles for an age- and sex-matched cohort without cardiovascular disease from the National Health and Nutrition Examination Survey (NHANES) III). Mean (SD) TC level was 5.71 (0.54)mmol/L (221 (21)mg/dL) (51st percentile), mean (SD) LDL-C level was 3.89 (0.43)mmol/L (150 (17)mg/dL) (60th percentile), mean (SD) HDL-C level was 0.94 (0.14)mmol/L (36 (5)mg/dL) for men and 1.03 (0.14)mmol/L (40 (5)mg/dL) for women (25th and 16th percentiles, respectively), and median (SD) triglyceride levels were 1.78 (0.86)mmol/L (158 (76)mg/dL) (63rd percentile). Intervention: Lovastatin (20-40mg daily) or placebo in addition to a low-saturated fat, low-cholesterol diet. Main Outcome Measures: First acute major coronary event defined as fatal or nonfatal myocardial infarction, unstable angina, or sudden cardiac death. Results: After an average follow-up of 5.2 years, lovastatin reduced the incidence of first acute major coronary events (183 vs 116 first events; relative risk (RR), 0.63; 95% confidence interval (CI), 0.50-0.79; P<.001), myocardial infarction (95 vs 57 myocardial infarctions; RR, 0.60; 95% CI, 0.43-0.83; P=.002), unstable angia (87 vs 60 first unstable angina events; RR, 0.68; 95% CI, 0.49-0.95; P=.02), coronary revascularization procedures (157 vs 106 procedures; RR, 0.67; 95% CI, 0.52-0.85; P=.001), coronary events (215 vs 163 coronary events; RR, 0.75; 95% CI, 0.61-0.92; P=.006), and cardiovascular events (255 vs 194 cardiovascular events; RR, 0.75; 95% CI, 0.62-0.91; P=.003). Lovastatin (20-40mg daily) reduced LDL-C by 25% to 2.96mmol/L (115mg/dL) and increased HDL-C by 6% to 1.02mmol/L (39mg/dL). There were no clinically relevant differences in safety parameters between treatment groups. Conclusions: Lovastatin reduces the risk for the first acute major coronary event in men and women with average TC and LDL-C levels and below-average HDL-C levels. These findings support the inclusion of HDL-C in risk-factor assessment, confirm the benefit of LDL-C reduction to a target goal, and suggest the need for reassessment of the National Cholesterol Education Program guidelines regarding pharmacological intervention.
    Keywords Primaerpraevention ; Koronarkrankheit ; Mann ; Frau ; Cholesterin ; Arzneimittel ; US-Bundesstaat
    Language English
    Document type Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0002-9955 ; 0098-7484 ; 0254-9077
    ISSN (online) 1538-3598
    ISSN 0002-9955 ; 0098-7484 ; 0254-9077
    Database Social Medicine (SOMED)

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  10. Article: Is atherosclerosis reversible?

    Gotto, Antonio M. Jr

    Journal - American Dietetic Association. May 1979. v. 74 (5)

    1979  

    Abstract: Abstract: Dietary modifications have been found to reverse atherosclerosis. The lowering of blood lipids in the human diet appears to decrease plaque size. Smoking is associated with the progression of plaque development, while non-smoking seems to ... ...

    Abstract Abstract: Dietary modifications have been found to reverse atherosclerosis. The lowering of blood lipids in the human diet appears to decrease plaque size. Smoking is associated with the progression of plaque development, while non-smoking seems to enhance plaque regression. Blood cholesterol and triglycerides were positively correlated with the rate of atherosclerosis in human beings. Patients who had undergone partial ileal bypass surgery showed no progression of the disease. Peripheral circulation improved in patients treated with diet and clofibrate. The presence of apoproteins and phospholipids can cause a net loss of cholesterol from incubated cells.
    Keywords diet ; atherosclerosis ; cholesterol ; lipids ; triacylglycerols ; diet therapy ; cardiovascular diseases
    Language English
    Dates of publication 1979-05
    Size p. 551-557., ill., charts.
    Document type Article
    Note Literature review.
    ZDB-ID 390806-9
    ISSN 1878-3570 ; 0002-8223
    ISSN (online) 1878-3570
    ISSN 0002-8223
    Database NAL-Catalogue (AGRICOLA)

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