考来替泊与烟酸联合治疗对冠状动脉粥样硬化和冠状动脉静脉搭桥移植物的有益作用。

Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts.

作者信息

Blankenhorn D H, Nessim S A, Johnson R L, Sanmarco M E, Azen S P, Cashin-Hemphill L

出版信息

JAMA. 1987 Jun 19;257(23):3233-40.

Abstract

The Cholesterol-Lowering Atherosclerosis Study (CLAS) was a randomized, placebo-controlled, angiographic trial testing combined colestipol hydrochloride and niacin therapy in 162 nonsmoking men aged 40 to 59 years with previous coronary bypass surgery. During two years of treatment there was a 26% reduction in total plasma cholesterol, a 43% reduction in low-density lipoprotein cholesterol, plus a simultaneous 37% elevation of high-density lipoprotein cholesterol. This resulted in a significant reduction in the average number of lesions per subject that progressed (P less than .03) and the percentage of subjects with new atheroma formation (P less than .03) in native coronary arteries. Also, the percentage of subjects with new lesions (P less than .04) or any adverse change in bypass grafts (P less than .03) was significantly reduced. Deterioration in overall coronary status was significantly less in drug-treated subjects than placebo-treated subjects (P less than .001). Atherosclerosis regression, as indicated by perceptible improvement in overall coronary status, occurred in 16.2% of colestipol-niacin treated vs 2.4% placebo treated (P = .002).

摘要

降胆固醇动脉粥样硬化研究（CLAS）是一项随机、安慰剂对照的血管造影试验，对162名年龄在40至59岁之间、曾接受过冠状动脉搭桥手术的非吸烟男性进行联合盐酸考来烯胺和烟酸治疗测试。在两年的治疗期间，血浆总胆固醇降低了26%，低密度脂蛋白胆固醇降低了43%，同时高密度脂蛋白胆固醇升高了37%。这导致每个受试者进展性病变的平均数量显著减少（P<0.03），以及天然冠状动脉中新发动脉粥样硬化形成的受试者百分比显著降低（P<0.03）。此外，有新病变的受试者百分比（P<0.04）或旁路移植物出现任何不良变化的受试者百分比（P<0.03）也显著降低。药物治疗组受试者总体冠状动脉状况的恶化程度明显低于安慰剂治疗组受试者（P<0.001）。总体冠状动脉状况有明显改善表明出现动脉粥样硬化消退，考来烯胺-烟酸治疗组为16.2%，而安慰剂治疗组为2.4%（P = 0.002）。