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Intensive cholesterol therapy with multiple drugs effective over long term
Date:6/25/2012

pol that binds to cholesterol. A second group took colestipol plus niacin. A third group took a placebo.

At the time of the FATS trial, lovastatin and other statins were still unproven. Statins have since become standard therapy to lower cholesterol. They work by blocking a chemical in the liver needed to make cholesterol.

Upon completion of the initial phase of FATS, some patients agreed to continue to be followed in an observational study, which lasted for 20 years.

In this observational study, one group received a single statin and the other group received intensive combination therapy. For the first 11 years, the intensive therapy consisted of lovastatin, niacin and colestipol. After 11 years, the regimen was changed to either lovastatin or simvastatin (Zocor), plus niacin. By the end of the study, 43 patients in the intensive therapy group were still being followed, and 26 patients in the single-medication group were still being followed.

After 20 years, the intensive therapy group had a LDL cholesterol level of 85 milligrams per deciliter, while the single-medication group had an LDL level of 103 mg/dL. The intensive therapy group also had lower levels of triglycerides (116 mg/dL vs. 167) and higher levels of good HDL (56 mg/dL vs. 46).

Researchers conducted an ultrasound exam to measure fatty buildup in the carotid artery, called carotid intima-media thickness (CIMT). The CIMT was 17 percent thicker in the single-medication group than in the intensive combination therapy group (1.056 mm vs. 0.902 mm). Researchers used this finding to calculate that the single-medication group ended the study with a much higher vascular age.

"These findings are the first to illustrate the benefits of long-term intensive combination lipid [cholesterol] therapy for 20 years in patients with atherosclerotic disease," Phan and colleagues wrote.


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Contact: Jim Ritter
jritter@lumc.edu
708-216-2445
Loyola University Health System
Source:Eurekalert

Page: 1 2

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