Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial.

@article{Nissen2004EffectOI,
  title={Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial.},
  author={Steven E Nissen and E. Murat Tuzcu and Paul Schoenhagen and B. Greg Brown and Peter Ganz and Robert A. Vogel and Tim Crowe and Gail Howard and Christopher J. Cooper and Bruce R. Brodie and Cindy L. Grines and Anthony N. DeMaria},
  journal={JAMA},
  year={2004},
  volume={291 9},
  pages={
          1071-80
        }
}
CONTEXT Statin drugs reduce both atherogenic lipoproteins and cardiovascular morbidity and mortality. However, the optimal strategy and target level for lipid reduction remain uncertain. OBJECTIVE To compare the effect of regimens designed to produce intensive lipid lowering or moderate lipid lowering on coronary artery atheroma burden and progression. DESIGN, SETTING, AND PATIENTS Double-blind, randomized active control multicenter trial (Reversal of Atherosclerosis with Aggressive Lipid… Expand

Paper Mentions

Interventional Clinical Trial
While statin treatment may induce plaque regression, the effect of statin on plaque composition with varying doses is unknown. This study assessed such effects by volumetric… Expand
ConditionsCoronary Disease, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Ultrasonography, Interventional
InterventionDrug
Interventional Clinical Trial
Recent evidence on the use of statin therapy indicates the potential for ultra-low levels of low-density lipoprotein (LDL-C) to provide greater protection from recurrent coronary heart… Expand
ConditionsAtherosclerosis
InterventionDrug
Effect of intensive lipid lowering on progression of coronary atherosclerosis: evidence for an early benefit from the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial.
  • S. Nissen
  • Medicine
  • The American journal of cardiology
  • 2005
TLDR
Post hoc analyses demonstrated that greater reductions in both lipid levels and hsCRP were associated with slower disease progression, which is related to the greater reduction in atherogenic lipoproteins and CRP in intensively treated patients. Expand
Effect of Intensive Versus Standard Lipid-Lowering Treatment With Atorvastatin on the Progression of Calcified Coronary Atherosclerosis Over 12 Months: A Multicenter, Randomized, Double-Blind Trial
TLDR
Over a period of 12 months, intensive atorvastatin therapy was unable to attenuate CAC progression compared with standard ator VASTatin therapy, and the possibility remains that the time window was too short to demonstrate an effect. Expand
Comparison of intensive and moderate lipid lowering with statins after acute coronary symptoms
TLDR
Among patients who have recently had an acute coronary syndrome, an intensive lipidlowering statin regimen provides greater protection against death or major cardiovascular events than does a standard regimen. Expand
Intensive lipid lowering with atorvastatin reduces progression of coronary atherosclerosis, as measured by intravascular ultrasound
TLDR
Atorvastatin significantly lowered the progression rate of coronary atherosclerosis compared with pravastatin at 18 months, indicating that target LDL-cholesterol levels lower than those recommended in current guidelines help prevent progression of coronary Atherosclerosis. Expand
Halting the progression of atherosclerosis with intensive lipid lowering: results from the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial.
  • S. Nissen
  • Medicine
  • The American journal of medicine
  • 2005
TLDR
The results show that intensive lipid reduction with atorvastatin 80 mg/day for 18 months halted the progression of coronary atherosclerosis, whereas more moderate lipid lowering with pravastatin 40 mg/ day was associated with progression. Expand
Role of dual lipid-lowering therapy in coronary atherosclerosis regression: Evidence from recent studies.
TLDR
This review summarizes recent evidence on the effects of dual lipid-lowering therapy on coronary atherosclerosis and suggests pharmacological inhibition of cholesterol absorption and PCSK9 activity provides potentially useful approaches for the therapeutic modulation of cholesterol metabolism in statin-treated patients. Expand
Aggressive Versus Moderate Lipid-Lowering Therapy in Hypercholesterolemic Postmenopausal Women: Beyond Endorsed Lipid Lowering With EBT Scanning (BELLES)
TLDR
In postmenopausal women, intensive statin therapy for 1 year caused a greater LDL reduction than moderate therapy but did not result in less progression of coronary calcification. Expand
Efficacy of Statin Therapy in Inducing Coronary Plaque Regression in Patients with Low Baseline Cholesterol Levels
TLDR
Serial IVUS data analysis indicated that statin therapy was less effective in inducing coronary plaque regression in patients with low cholesterol levels but more effective in those with high cholesterol levels at baseline. Expand
Impact of the Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis In Myocardial Infarction 22/Reversal of Atherosclerosis With Aggressive Lipid Lowering Trials on Trends in Intensive Versus Moderate Statin Therapy in Ontario, Canada
TLDR
The publication of the PROVE IT–TIMI 22 and REVERSAL trials resulted in a significant sustained increase in the use of intensive compared with moderate statin therapy, which was evident primarily in an increased use of high-dose atorvastatin and did not appear to be generalizable to other statins. Expand
Effects of Intensive Versus Moderate Lipid-Lowering Therapy on Myocardial Ischemia in Older Patients With Coronary Heart Disease: Results of the Study Assessing Goals in the Elderly (SAGE)
TLDR
It is demonstrated that older men and women with coronary artery disease benefit from intensive statin therapy and the Study Assessing Goals in the Elderly (SAGE) demonstrates that low-density lipoprotein cholesterol–lowering thresholds for ischemia and major acute cardiovascular events may differ. Expand
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