Implications of the Atorvastatin

被引:4
作者
Daniel Eisenberg
机构
[1] Foothill Cardiology/California Heart Care,
关键词
Atorvastatin; Pravastatin; Scandinavian Simvastatin Survival Study; Stable Coronary Heart Disease; Additional Clinical Benefit;
D O I
10.1007/s11886-000-0057-7
中图分类号
学科分类号
摘要
The underlying disorder in the vast majority of cases of cardiovascular disease is atherosclerosis, for which low-density lipoprotein cholesterol is recognized as a major risk factor. Data from epidemiologic studies have suggested that lower cholesterol levels are associated with a lower overall risk of morbidity and mortality due to coronary heart disease. Numerous clinical trials with lipid-lowering agents support these epidemiologic data. Of these, studies with the HMG-CoA (3-hydroxy 3-methylglutaryl coenzyme A) reductase inhibitors, or statins, have shown the greatest lipid-lowering effects. Data from recent trials such as the Atorvastatin Versus Revascularization Treatment contribute to a growing body of evidence that suggests that aggressive reduction of cholesterol can yield additional clinical benefits above and beyond that observed with less robust treatment regimens. Aggressive cholesterol-lowering strategies have the potential therefore to have a significant impact on levels of atherosclerotic disease throughout the westernized world. Such effects argue in favor of renaming the entire class of drugs as anti-atherosclerotic rather than lipid-lowering agents.
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页码:433 / 438
页数:5
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共 80 条
  • [11] Peto R(1992)A comparison of angioplasty with medical therapy in the treatment of single-vessel coronary artery disease N Engl J Med 326 10-16
  • [12] Collins R(1998)Two- to three-year follow-up of patients with single-vessel coronary artery disease randomized to PTCA or medical therapy (results of a VA cooperative study) Am J Cardiol 82 1445-1450
  • [13] Wakugami K(1997)Percutaneous transluminal coronary angioplasty versus medical therapy for stable angina pectoris: outcomes for patients with double-vessel versus single-vessel coronary artery disease in a Veterans Affairs Cooperative randomized trial J Am Coll Cardiol 29 1505-1511
  • [14] Iseki K(1995)The Medicine, Angioplasty or Surgery Study (MASS): a prospective, randomized trial of medical therapy, balloon angioplasty or bypass surgery for single proximal left anterior descending artery stenoses J Am Coll Cardiol 26 1600-1605
  • [15] Kimura Y(1997)Coronary angioplasty versus medical therapy for angina: the second Randomised Intervention Treatment of Angina (RITA-2) trial Lancet 350 461-468
  • [16] Sacks FM(1999)Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease N Engl J Med 341 70-76
  • [17] Pfeffer MA(1997)The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts N Engl J Med 336 153-162
  • [18] Moyé LA(1998)Cholesterol reduction yields clinical benefit: impact of statin trials Circulation 97 946-952
  • [19] Shepherd J(1994)Second report of the Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel II) Circulation 89 1329-1445
  • [20] Cobbe SM(1999)Influence of maternal hypercholesterolaemia during pregnancy on progression of early atherosclerotic lesions in childhood: Fate of Early Lesions in Children (FELIC) study Lancet 354 1234-1241