Abstract
Over the past several years, results of clinical trials of lipid lowering have increased
our understanding of the pathophysiology of coronary atherosclerosis and ischemia.
Evidence is accumulating that cholesterol lowering has potential anti-ischemic effects
and may have immediate consequences that have a favorable impact on coronary events,
possibly even acute coronary syndromes. Yet, less than one half of all patients hospitalized
for acute coronary syndromes have their cardiovascular risks appropriately modified.
The results of recent statin trials provide impetus for the implementation of aggressive
risk-reduction strategies in patients with coronary atherosclerosis, including those
with recent acute coronary syndromes. Prevention is now a viable therapeutic goal.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels.N Engl J Med. 1996; 335: 1001-1009
- Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia.N Engl J Med. 1995; 333: 1301-1307
- Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels.JAMA. 1998; 279: 1615-1622
- Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease.Lancet. 1994; 344: 1383-1389
- Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.N Engl J Med. 1998; 339: 1349-1357
- Beneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients with coronary artery disease.N Engl J Med. 1995; 332: 481-487
- Lipid lowering and plaque regression.Circulation. 1993; 87: 1781-1791
- Coronary plaque disruption.Circulation. 1995; 92: 657-671
- Atlas of Coronary Artery Disease. Lippincott-Raven, Philadelphia1998
- Pathogenic mechanisms of atherosclerosis.Am J Med. 1996; 101: 10S-16S
- Single LDL apheresis improves endothelium-dependent vasodilation in hypercholesterolemic humans.Circulation. 1997; 95: 76-82
- Coronary flow reserve is impaired in young men with familial hypercholesterolemia.J Am Coll Cardiol. 1996; 28: 1705-1711
- ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations.Circulation. 1999; 99: 2829-2848
- The treatment gap in coronary artery disease and heart failure.Am J Cardiol. 1997; 80: 45H-52H
- Recent trends in the identification and treatment of high blood cholesterol by physicians.JAMA. 1993; 269: 1133-1138
- Divergent reporting of coronary risk factors before coronary artery bypass surgery.Am J Cardiol. 1995; 75: 736-737
- Low incidence of assessment and modification of risk factors in acute care patients at high risk for cardiovascular events, particularly among females and the elderly.Am J Cardiol. 1995; 76: 570-573
- Improving physician compliance with a health maintenance protocol.J Fam Pract. 1995; 19: 341-344
- Physician non-compliance with the 1993 National Cholesterol Education Program (NCEP-ATP II) Guidelines.Circulation. 1998; 98: 851-855
- Biological mechanisms for the clinical success of lipid-lowering in coronary artery disease and the use of surrogate end-points.Curr Opin Lipidol. 1996; 7: 389-397
- Chronic inhibition of nitric oxide production accelerates neointima formation and impairs endothelial function in hypercholesterolemic rabbits.Arterioscler Thromb. 1994; 14: 753-759
- Role of endothelial dysfunction in coronary artery disease and implications for therapy.Am J Cardiol. 1997; 80: 11I-16I
- Modulation of coronary vasomotor tone in humans.Circulation. 1991; 83: 391-401
- The effect of cholesterol-lowering and antioxidant therapy on endothelium-dependent coronary vasomotion.N Engl J Med. 1995; 332: 488-493
- Effect of a single high-fat meal on endothelial function in healthy subjects.Am J Cardiol. 1997; 79: 350-354
- Beneficial effect of cholesterol-lowering therapy on coronary endothelium-dependent relaxation in hypercholesterolaemic patients.Lancet. 1993; 341: 1496-1500
- Cholesterol reduction rapidly improves endothelial function after acute coronary syndromes.Circulation. 1999; 99: 3227-3233
- Short-term cholesterol lowering decreases size and severity of perfusion abnormalities by positron emission tomography after dipyridamole in patients with coronary artery disease.Circulation. 1994; 89: 1530-1538
- Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease.Circulation. 1997; 95: 324-328
- Levels of soluble cell adhesion molecules in patients with dyslipidemia.Circulation. 1996; 93: 1334-1338
- Inhibitory effect of fluvastatin, an HMG-CoA reductase inhibitor, on the expression of adhesion molecules on human monocyte cell line.Int J Immunopharmacol. 1996; 18: 669-675
- Relationship between mevalonate pathway and arterial myocyte proliferation.Atherosclerosis. 1993; 101: 117-125
- Effects of long-term treatment with lovastatin on the clotting system and blood platelets.Ann Hematol. 1992; 64: 196-201
- Hyperlipidemia and coronary disease.Circulation. 1995; 92: 3172-3177
- Design, rationale, and baseline characteristics of the Prospective Pravastatin Pooling (PPP) project—a combined analysis of three large-scale randomized trials.Am J Cardiol. 1995; 76: 899-905
- Aggressive lipid lowering therapy compared with angioplasty in stable coronary artery disease.N Engl J Med. 1999; 341: 70-76
- Pravastatin prevents clinical events in revascularized patients with average cholesterol concentrations.J Am Coll Cardiol. 1999; 34: 106-112
- Time course of serum lipids and apolipoproteins after acute myocardial infarction.Acta Cardiol. 1997; 52: 107-116
- Short- and long-term effects of intensified versus conventional antilipidemic therapy in patients with coronary heart disease.Z Kardiol. 1999; 88: 582-590
Schwartz, GC, Olsson AG, Ezekowitz MD, Ganz P, Oliver MF, Waters D, Zeiher A, Chaitman BR, Leslie S, Stern T, for the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL Study: a randomized controlled trial. JAMA 285:1711–1718.
- Improved treatment of cardiovascular disease by implementation of a cardiac hospitalization atherosclerosis management program.Circulation. 1997; 96 ([abstract 364.47]): I-67
Article info
Identification
Copyright
© 2001 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
