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Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group.

Publication ,  Journal Article
Weintraub, WS; Boccuzzi, SJ; Klein, JL; Kosinski, AS; King, SB; Ivanhoe, R; Cedarholm, JC; Stillabower, ME; Talley, JD; DeMaio, SJ
Published in: N Engl J Med
November 17, 1994

BACKGROUND: Experimental and clinical observations suggest that lowering serum lipid levels may reduce the risk of restenosis after coronary angioplasty. We report the results of a prospective, randomized, double-blind trial evaluating whether lowering lipid levels with lovastatin can prevent or delay restenosis after angioplasty. METHODS: Seven to 10 days before angioplasty, we randomly assigned eligible patients to receive lovastatin (40 mg orally twice daily) or placebo. Patients who underwent successful, complication-free, first-time angioplasty of a native vessel (the index lesion) continued to receive therapy for six months, when a second coronary angiogram was obtained. The primary end point was the extent of restenosis of the index lesion, as assessed by quantitative coronary arteriography. Of 404 patients randomly assigned to study groups, 384 underwent angioplasty; 354 of the procedures were successful, and 321 patients underwent angiographic restudy at six months. RESULTS: At base line, the patients in the lovastatin group (n = 203) and the placebo group (n = 201) were similar with respect to demographic clinical, angiographic, and laboratory characteristics. At base line the mean (+/- SD) degree of stenosis, expressed as a percentage of the diameter of the vessel, was 64 +/- 11 percent in the lovastatin group, as compared with 63 +/- 11 percent in the placebo group (P = 0.22). Despite a 42 percent reduction in the serum level of low-density lipoprotein cholesterol in the lovastatin group, after six months of treatment the amount of stenosis seen in the second angiogram was 46 +/- 20 percent in the placebo group, as compared with 44 +/- 21 percent in the lovastatin group (P = 0.50). Similarly, there were no significant differences in minimal luminal diameter or other measures of restenosis. A trend was noted toward more myocardial infarctions in the lovastatin group, as a result of acute vessel closure or restenosis at the site of angioplasty, but there were no other important differences between the two groups in the frequency of fatal or nonfatal events at six months. CONCLUSIONS: Treatment with high-dose lovastatin initiated before coronary angioplasty does not prevent or delay the process of restenosis in the first six months after the procedure.

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Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

November 17, 1994

Volume

331

Issue

20

Start / End Page

1331 / 1337

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Recurrence
  • Prospective Studies
  • Middle Aged
  • Male
  • Lovastatin
  • Hyperlipidemias
  • Humans
  • General & Internal Medicine
  • Female
 

Citation

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Weintraub, W. S., Boccuzzi, S. J., Klein, J. L., Kosinski, A. S., King, S. B., Ivanhoe, R., … DeMaio, S. J. (1994). Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group. N Engl J Med, 331(20), 1331–1337. https://doi.org/10.1056/NEJM199411173312002
Weintraub, W. S., S. J. Boccuzzi, J. L. Klein, A. S. Kosinski, S. B. King, R. Ivanhoe, J. C. Cedarholm, M. E. Stillabower, J. D. Talley, and S. J. DeMaio. “Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group.N Engl J Med 331, no. 20 (November 17, 1994): 1331–37. https://doi.org/10.1056/NEJM199411173312002.
Weintraub WS, Boccuzzi SJ, Klein JL, Kosinski AS, King SB, Ivanhoe R, et al. Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group. N Engl J Med. 1994 Nov 17;331(20):1331–7.
Weintraub, W. S., et al. “Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group.N Engl J Med, vol. 331, no. 20, Nov. 1994, pp. 1331–37. Pubmed, doi:10.1056/NEJM199411173312002.
Weintraub WS, Boccuzzi SJ, Klein JL, Kosinski AS, King SB, Ivanhoe R, Cedarholm JC, Stillabower ME, Talley JD, DeMaio SJ. Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group. N Engl J Med. 1994 Nov 17;331(20):1331–1337.
Journal cover image

Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

November 17, 1994

Volume

331

Issue

20

Start / End Page

1331 / 1337

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Recurrence
  • Prospective Studies
  • Middle Aged
  • Male
  • Lovastatin
  • Hyperlipidemias
  • Humans
  • General & Internal Medicine
  • Female