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Cholesterol Drug Fails to Slow Progression of Coronary Disease,,Cleveland Clinic Study Reports

P Inhibition and HDL Elevation" (ILLUSTRATE) trial. All patients had a clinical indication for cardiac catheterization, had a baseline intravascular ultrasound (IVUS) and received 10-80 gm of atorvastatin adjusted during a two- to 10-week period until LDL levels reached national guidelines.

Patients were then randomized to receive either 60 mg of torcetrapib or a matching placebo for two years. At the end of the treatment period, a second IVUS was performed, examining the same coronary arteries. Researchers measured the change in plaque volume in the artery, comparing the baseline to the follow-up ultrasound. They also measured patients' blood cholesterol levels and biomarkers of inflammation at several points during the trial.

Patients in the torcetrapib/atorvastatin group experienced a 61 percent relative increase in HDL cholesterol levels and a 20 percent relative decrease in LDL levels, as compared with patients in the atorvastatin-only group. Despite those results, there was no statistical difference between the two groups in plaque volume changes. Plaque volume increased by 0.19 percent in the atorvastatin-only patients and 0.12 percent in the combination group, p = 0.72. Torectrapib was also associated with a substantial increase in blood pressure, averaging 4.6 mm.

IVUS is a technique in which a tiny ultrasound probe is inserted into the coronary arteries, providing a precise and reproducible method for determining the change in plaque, or atheroma, burden during treatment.

Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the nation's best hospitals
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