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Cardiac events better treated with intense cholesterol-lowering regime

Investigators from the Weatherhead P.E.T. Center for Preventing and Reversing Atherosclerosis in Houston, Texas, United States, have suggested in a new study that intense lifestyle changes plus pharmacologic lipid treatment reduces myocardial perfusion abnormalities and cardiac events to a greater extent than usual-care cholesterol lowering drugs. They studied 409 patients with coronary artery// disease by performing myocardial perfusion imaging at baseline and after 2.6 years with software-based quantitative measurement of perfusion defects. Cardiac events were monitored during an additional five-year follow-up period.

The patients who participated in the study were divided into three categories depending on the type of treatment that was given to them. The "poor" treatment group included patients who were neither dieting nor taking lipid-lowering drugs and patients who were smoking. The "moderate" treatment group was put on the American Heart Association diet with lipid lowering drugs or a strict diet with less than 10% of calories from fat. And, the "maximal" treatment group consisted of patients who were put on strict low-fat diet, regular exercise and lipid active drugs.

Researchers, during the five-year follow-up period, found out that cardiac events occurred in 20.3% of the patients in the moderate treatment group and 30.6% of patients in the poor treatment group. In contrast, cardiac events occurred in only 6.6% of the patients in the maximal treatment group. Also, the size and severity of perfusion abnormalities decreased in the maximal treatment group but increased in both the poor and moderate treatment groups. Changes in myocardial perfusion paralleled the intensity of treatment and predicted cardiac events.


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