Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease

Thomas C. Andrews, Khether Raby, Joan Barry, Cameron L. Naimi, Elizabeth Allred, Peter Ganz, Andrew P. Sehvyn

Research output: Contribution to journalArticle

207 Citations (Scopus)

Abstract

Background: Cholesterol lowering is associated with a reduction in cardiovascular morbidity and mortality. This study sought to determine whether cholesterol lowering also results in a reduction of myocardial ischemia during daily life. Methods and Results: We enrolled 40 patients with proven coronary artery disease, total serum cholesterol between 191 and 327 mg/dL, and at least one episode of ST-segment depression on ambulatory ECG monitoring. Twenty patients were randomized to an American Heart Association Step 1 diet plus placebo (placebo group) and 20 to the same diet plus lovastatin (treatment group). Serum cholesterol and LDL cholesterol levels and ambulatory monitoring were repeated after 4 to 6 months of therapy. The two groups were comparable with respect to baseline characteristics, number of episodes of ST segment depression, and baseline serum cholesterol levels. The treatment group had lower mean total and LDL cholesterol levels at study end and experienced a significant reduction in the number of episodes of ST- segment depression compared with the placebo group. ST segment depression was completely resolved in 13 of 20 patients (65%) in the treatment group versus 2 of 20 (10%) in the placebo group. The treatment group exhibited a highly significant reduction in ischemia (P<.001). By logistic regression, treatment with diet and lovastatin was an independent predictor of ischemia resolution. Conclusions: Cholesterol lowering with lovastatin appears to be effective in eliminating myocardial ischemia during daily life in a significant proportion of patients.

Original languageEnglish (US)
Pages (from-to)324-328
Number of pages5
JournalCirculation
Volume95
Issue number2
StatePublished - 1997

Fingerprint

Myocardial Ischemia
Coronary Disease
Cholesterol
Lovastatin
Placebos
Ambulatory Monitoring
Diet
LDL Cholesterol
Therapeutics
Ischemia
Serum
Coronary Artery Disease
Electrocardiography
Logistic Models
Morbidity
Mortality

Keywords

  • arteriosclerosis
  • ischemia
  • lipoproteins

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Andrews, T. C., Raby, K., Barry, J., Naimi, C. L., Allred, E., Ganz, P., & Sehvyn, A. P. (1997). Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease. Circulation, 95(2), 324-328.

Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease. / Andrews, Thomas C.; Raby, Khether; Barry, Joan; Naimi, Cameron L.; Allred, Elizabeth; Ganz, Peter; Sehvyn, Andrew P.

In: Circulation, Vol. 95, No. 2, 1997, p. 324-328.

Research output: Contribution to journalArticle

Andrews, TC, Raby, K, Barry, J, Naimi, CL, Allred, E, Ganz, P & Sehvyn, AP 1997, 'Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease', Circulation, vol. 95, no. 2, pp. 324-328.
Andrews TC, Raby K, Barry J, Naimi CL, Allred E, Ganz P et al. Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease. Circulation. 1997;95(2):324-328.
Andrews, Thomas C. ; Raby, Khether ; Barry, Joan ; Naimi, Cameron L. ; Allred, Elizabeth ; Ganz, Peter ; Sehvyn, Andrew P. / Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease. In: Circulation. 1997 ; Vol. 95, No. 2. pp. 324-328.
@article{93cc3481db5147018ba0327732463495,
title = "Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease",
abstract = "Background: Cholesterol lowering is associated with a reduction in cardiovascular morbidity and mortality. This study sought to determine whether cholesterol lowering also results in a reduction of myocardial ischemia during daily life. Methods and Results: We enrolled 40 patients with proven coronary artery disease, total serum cholesterol between 191 and 327 mg/dL, and at least one episode of ST-segment depression on ambulatory ECG monitoring. Twenty patients were randomized to an American Heart Association Step 1 diet plus placebo (placebo group) and 20 to the same diet plus lovastatin (treatment group). Serum cholesterol and LDL cholesterol levels and ambulatory monitoring were repeated after 4 to 6 months of therapy. The two groups were comparable with respect to baseline characteristics, number of episodes of ST segment depression, and baseline serum cholesterol levels. The treatment group had lower mean total and LDL cholesterol levels at study end and experienced a significant reduction in the number of episodes of ST- segment depression compared with the placebo group. ST segment depression was completely resolved in 13 of 20 patients (65{\%}) in the treatment group versus 2 of 20 (10{\%}) in the placebo group. The treatment group exhibited a highly significant reduction in ischemia (P<.001). By logistic regression, treatment with diet and lovastatin was an independent predictor of ischemia resolution. Conclusions: Cholesterol lowering with lovastatin appears to be effective in eliminating myocardial ischemia during daily life in a significant proportion of patients.",
keywords = "arteriosclerosis, ischemia, lipoproteins",
author = "Andrews, {Thomas C.} and Khether Raby and Joan Barry and Naimi, {Cameron L.} and Elizabeth Allred and Peter Ganz and Sehvyn, {Andrew P.}",
year = "1997",
language = "English (US)",
volume = "95",
pages = "324--328",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease

AU - Andrews, Thomas C.

AU - Raby, Khether

AU - Barry, Joan

AU - Naimi, Cameron L.

AU - Allred, Elizabeth

AU - Ganz, Peter

AU - Sehvyn, Andrew P.

PY - 1997

Y1 - 1997

N2 - Background: Cholesterol lowering is associated with a reduction in cardiovascular morbidity and mortality. This study sought to determine whether cholesterol lowering also results in a reduction of myocardial ischemia during daily life. Methods and Results: We enrolled 40 patients with proven coronary artery disease, total serum cholesterol between 191 and 327 mg/dL, and at least one episode of ST-segment depression on ambulatory ECG monitoring. Twenty patients were randomized to an American Heart Association Step 1 diet plus placebo (placebo group) and 20 to the same diet plus lovastatin (treatment group). Serum cholesterol and LDL cholesterol levels and ambulatory monitoring were repeated after 4 to 6 months of therapy. The two groups were comparable with respect to baseline characteristics, number of episodes of ST segment depression, and baseline serum cholesterol levels. The treatment group had lower mean total and LDL cholesterol levels at study end and experienced a significant reduction in the number of episodes of ST- segment depression compared with the placebo group. ST segment depression was completely resolved in 13 of 20 patients (65%) in the treatment group versus 2 of 20 (10%) in the placebo group. The treatment group exhibited a highly significant reduction in ischemia (P<.001). By logistic regression, treatment with diet and lovastatin was an independent predictor of ischemia resolution. Conclusions: Cholesterol lowering with lovastatin appears to be effective in eliminating myocardial ischemia during daily life in a significant proportion of patients.

AB - Background: Cholesterol lowering is associated with a reduction in cardiovascular morbidity and mortality. This study sought to determine whether cholesterol lowering also results in a reduction of myocardial ischemia during daily life. Methods and Results: We enrolled 40 patients with proven coronary artery disease, total serum cholesterol between 191 and 327 mg/dL, and at least one episode of ST-segment depression on ambulatory ECG monitoring. Twenty patients were randomized to an American Heart Association Step 1 diet plus placebo (placebo group) and 20 to the same diet plus lovastatin (treatment group). Serum cholesterol and LDL cholesterol levels and ambulatory monitoring were repeated after 4 to 6 months of therapy. The two groups were comparable with respect to baseline characteristics, number of episodes of ST segment depression, and baseline serum cholesterol levels. The treatment group had lower mean total and LDL cholesterol levels at study end and experienced a significant reduction in the number of episodes of ST- segment depression compared with the placebo group. ST segment depression was completely resolved in 13 of 20 patients (65%) in the treatment group versus 2 of 20 (10%) in the placebo group. The treatment group exhibited a highly significant reduction in ischemia (P<.001). By logistic regression, treatment with diet and lovastatin was an independent predictor of ischemia resolution. Conclusions: Cholesterol lowering with lovastatin appears to be effective in eliminating myocardial ischemia during daily life in a significant proportion of patients.

KW - arteriosclerosis

KW - ischemia

KW - lipoproteins

UR - http://www.scopus.com/inward/record.url?scp=0031018962&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031018962&partnerID=8YFLogxK

M3 - Article

C2 - 9008444

AN - SCOPUS:0031018962

VL - 95

SP - 324

EP - 328

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 2

ER -