Pravastatin limitation of atherosclerosis in the coronary arteries (PLAC I): Reduction in atherosclerosis progression and clinical events
Journal of the American College of CardiologyPublished 1 November 1995
Bertram Pitt, G.B.John Mancini, Stephen G. Ellis, Howard Rosman, Jong-Soon Park, Mark E. McGovern
Citations429
SJR quartileQ1
SJR score9.02
SNIP6.30
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
In patients with coronary artery disease and mild to moderate cholesterol elevations, pravastatin reduces progression of coronary atherosclerosis and myocardial infarction and increases the potential for a relatively rapid decrease in the clinical manifestations of coronary arteries disease with lipid lowering.
Abstract
In patients with coronary artery disease and mild to moderate cholesterol elevations, pravastatin reduces progression of coronary atherosclerosis and myocardial infarction. The time course of event reduction increases the potential for a relatively rapid decrease in the clinical manifestations of coronary artery disease with lipid lowering.
Keywords
MedicineBiochemistry, Genetics and Molecular Biology
JAMASummary of the Second Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II)
27,886 Citations1993Scott M. Grundy
Dairy therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD, and the fundamental approach to treatment is comparable.
New England Journal of MedicineParadoxical Vasoconstriction Induced by Acetylcholine in Atherosclerotic Coronary Arteries
2,425 Citations1986Paul L. Ludmer, Andrew P. Selwyn +5 more
The preliminary findings suggest that the abnormal vascular response to acetylcholine may represent a defect in endothelial vasodilator function, and may be important in the pathogenesis of coronary vasospasm.
New England Journal of MedicineRegression of Coronary Artery Disease as a Result of Intensive Lipid-Lowering Therapy in Men with High Levels of Apolipoprotein B
2,166 Citations1990Greg Brown, John J. Albers +8 more
In men with coronary artery disease who were at high risk for cardiovascular events, intensive lipid-lowering therapy reduced the frequency of progression of coronary lesions, increased the frequencyof regression, and reduced the incidence of cardiovascular events.
The LancetMediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease
2,134 Citations1994M. de Lorgeril, S. Renaud +7 more
An alpha-linolenic acid-rich Mediterranean diet seems to be more efficient than presently used diets in the secondary prevention of coronary events and death.
The LancetCan lifestyle changes reverse coronary heart disease?
2,112 Citations1990Dean Ornish, Shirley Brown +8 more
Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.
The LancetAntibodies to glutamic acid decarboxylase as predictors of insulin-dependent diabetes mellitus before clinical onset of disease
1,698 Citations1994J. Tuomilehto, Gabriele Vidgrén +8 more
Anti-GAD is a valuable early predictive marker and is associated with a very high risk for development of IDDM, and was measured in prediabetic sera from 151 women aged 20-39 years with newly diagnosed diabetes mellitus who had been identified through a nationwide diabetes register.
JAMABeneficial Effects of Combined Colestipol-Niacin Therapy on Coronary Atherosclerosis and Coronary Venous Bypass Grafts
1,643 Citations1987David H. Blankenhorn
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.
CirculationCan coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease?
1,471 Citations1988William C. Little, M Constantinescu +5 more
Assessment of the angiographic severity of coronary stenosis may be inadequate to accurately predict the time or location of a subsequent coronary occlusion that will produce a myocardial infarction.
Journal of the American College of CardiologyAngiographic progression of coronary artery disease and the development of myocardial infarction
1,453 Citations1988John A. Ambrose, Mark Tannenbaum +7 more
It is suggested that myocardial infarction frequently develops from previously nonsevere lesions, and proximal lesion location is the only significant predictor of evolution of lesions greater than or equal to 50% to infarctions.
BMJBy how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease?
1,220 Citations1994M R Law, Nicholas Wald +1 more
The results from the cohort studies, international comparisons, and clinical trials are remarkably consistent and estimate that a long term reduction in serum cholesterol concentration of 0.6 mmol/l (10%), which can be achieved by moderate dietary change,owers the risk of ischaemic heart disease by 50%" at age 40, falling to 20% at age 70.
New England Journal of MedicineThe Effect of Cholesterol-Lowering and Antioxidant Therapy on Endothelium-Dependent Coronary Vasomotion
1,111 Citations1995Todd J. Anderson, Ian T. Meredith +4 more
The improvement in endothelium-dependent vasomotion with cholesterol-lowering and antioxidant therapy may have important implications for the activity of myocardial ischemia and may explain in part the reduced incidence of adverse coronary events that is known to result from cholesterol- Lowering therapy.
New England Journal of MedicineBeneficial Effects of Cholesterol-Lowering Therapy on the Coronary Endothelium in Patients with Coronary Artery Disease
1,098 Citations1995Charles B. Treasure, J. Larry Klein +8 more
Cholesterol lowering with lovastatin significantly improved endothelium-mediated responses in the coronary arteries of patients with atherosclerosis, and improvement in the local regulation of coronary arterial tone could potentially relieve ischemic symptoms and signal the stabilization of the atherosclerotic plaque.
Journal of Occupational and Environmental MedicineBeneficial Effects of Cholesterol-Lowering Therapy on the Coronary Endothelium in Patients with Coronary Artery Disease
1,071 Citations1996&NA;
New England Journal of MedicineEffect of Partial Ileal Bypass Surgery on Mortality and Morbidity from Coronary Heart Disease in Patients with Hypercholesterolemia
1,008 Citations1990Hēnry Buchwald, Richard L. Varco +22 more
Significant evidence is provided supporting the beneficial effects of lipid modification in the reduction of atherosclerosis progression and sustained improvement in the blood lipid patterns of patients who have had a myocardial infarction and reduces their subsequent morbidity due to coronary heart disease.
CirculationEffects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease. The Stanford Coronary Risk Intervention Project (SCRIP).
883 Citations1994William L. Haskell, Edwin L. Alderman +8 more
Intensive multifactor risk reduction conducted over 4 years favorably altered the rate of luminal narrowing in coronary arteries of men and women with coronary artery disease and decreased hospitalizations for clinical cardiac events.
The LancetEffects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas' Atherosclerosis Regression Study (STARS)
845 Citations1992Gerald F. Watts, B. Lewis +6 more
The findings support the use of a lipid-lowering diet, and if necessary of appropriate drug treatment, in men with CHD who have even mildly raised serum cholesterol concentrations.
JAMARegression of Coronary Atherosclerosis During Treatment of Familial Hypercholesterolemia With Combined Drug Regimens
801 Citations1990John P. Kane
Reduction of low-density lipoprotein cholesterol levels can induce regression of atherosclerotic lesions of the coronary arteries in patients with familial hypercholesterolemia, and the anticipation of benefit from treatment applies to women and men alike.
Journal of Clinical InvestigationEndothelium-mediated coronary blood flow modulation in humans. Effects of age, atherosclerosis, hypercholesterolemia, and hypertension.
674 Citations1993Andreas M. Zeiher, H. Drexler +2 more
Hypercholesterolemia and advanced age selectively impair endothelium-mediated relaxation of the coronary microvasculature in response to acetylcholine, whereas endothelial dysfunction is restricted to epicardial arteries in age-matched normocholesterolemic patients with evidence of coronary atherosclerosis and/or hypertension.
The LancetEffect of simvastatin on coronary atheroma: the Multicentre Anti-Atheroma Study (MAAS)
650 Citations1994MAAS Investigators
The trial showed that 20 mg simvastatin daily over 4 years reduces hyperlipidaemia and slows progression of diffuse and focal coronary atherosclerosis.
Annals of Internal MedicineCoronary Angiographic Changes with Lovastatin Therapy: The Monitored Atherosclerosis Regression Study (MARS)
640 Citations1993David H. Blankenhorn, Stanley P. Azen +10 more
In the Cholesterol Lowering Atherosclerosis Study (CLAS), it was shown that diet in conjunction with colestipol and niacin therapy had a beneficial effect on coronary artery lesions at 2 and 4 years based on the global change score [5, 15] and at 2 yearsbased on quantitative coronary angiography [16]; CLAS was the only angiographic trial to have used both the findings of quantitative coronaryAngiography and theglobal change score as end points.
CirculationReduction in serum cholesterol with pravastatin improves endothelium-dependent coronary vasomotion in patients with hypercholesterolemia.
600 Citations1994K. Egashira, Y Hirooka +5 more
Proceedings of the National Academy of SciencesMacrophage foam cells from experimental atheroma constitutively produce matrix-degrading proteinases.
555 Citations1995Zorina S. Galis, Galina K. Sukhova +3 more
Lipid-laden macrophages are isolated from rabbit aortic lesions produced by a combination of hypercholesterolemia and balloon injury and show elaborate MMPs capable of degrading the major constituents of vascular extracellular matrix even without further stimulation.
CirculationEffects of monotherapy with an HMG-CoA reductase inhibitor on the progression of coronary atherosclerosis as assessed by serial quantitative arteriography. The Canadian Coronary Atherosclerosis Intervention Trial.
505 Citations1994David D. Waters, Lyall Higginson +5 more
Lovastatin slows the progression of coronary atherosclerosis and inhibits the development of new coronary lesions and in patients whose baseline total or LDL cholesterol levels were above the group median.
The LancetBeneficial effect of cholesterol-lowering therapy on coronary endothelium-dependent relaxation in hypercholesterolaemic patients
453 Citations1993Wa‐Hung Leung, Chu‐Pak Lau +1 more
Impairment of endothelium-dependent (acetylcholine-induced) dilation of the epicardial coronary arteries in hypercholesterolaemic patients with angiographically normal coronary arteries is thus reversible by reducing serum cholesterol.
CirculationAutomated quantitative coronary arteriography: morphologic and physiologic validation in vivo of a rapid digital angiographic method.
370 Citations1987G.B. John Mancini, Sandra B. Simon +4 more
Direct anatomic and physiologic validation in vivo of a new and rapid coronary quantitation method suitable for analysis of both digital angiograms and cineangiograms is provided.
CirculationPrognostic significance of progression of coronary atherosclerosis.
277 Citations1993David D. Waters, TP Craven +1 more
Coronary progression is a strong, independent predictor of future coronary events, particularly cardiac death, and its use as a surrogate end point in clinical trials is justified.
Journal of the American College of CardiologyProgression of coronary atherosclerosis: Is coronary spasm related to progression?
250 Citations1991Masakiyo Nobuyoshi, Makoto Tanaka +7 more
Arteriosclerosis and Thrombosis A Journal of Vascular BiologyGeorge Lyman Duff Memorial Lecture. Arterial imaging and atherosclerosis reversal.
226 Citations1994David H. Blankenhorn, Howard N. Hodis
Evidence for the reversibility of atherosclerosis and augmentation of angiography with non-invasive arterial wall imaging is explored, finding that regression and stabilization are 1.5 to 2 times more common in treated than placebo subjects, and progression is reduced by half in treated subjects.
CirculationPrognostic significance of progression of coronary atherosclerosis.
199 Citations1993DWaters, T ECraven +1 more
The American Journal of CardiologyEffects of pravastatin in patients with serum total cholesterol levels from 5.2 to 7.8 mmol/liter (200 to 300 mg/dl) plus two additional atherosclerotic risk factors
182 Citations1993
The American Journal of CardiologyPlatelet aggregation, coronary artery disease progression and future coronary events
52 Citations1994Jules Y.T. Lam, Jean-Gilles Latour +2 more
Patients with coronary disease progression and future coronary events have an enhanced thrombin-induced platelet aggregation, which may be a marker of increased risk and may play a causative role in the development of coronary events.
The American Journal of CardiologyDesign and recruitment in the United States of a multicenter quantitative angiographic trial of pravastatin to limit atherosclerosis in the coronary arteries (PLAC I)
48 Citations1993Bertram Pitt, Stephen G. Ellis +4 more
Testing the effect of pravastatin, a new, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, on the progression of coronary artery disease in patients with moderate hypercholesterolemia found it to be safe and effective.
The American Journal of CardiologyLong-term prognosis of medically treated patients with acute myocardial infarction and one-vessel coronary artery disease
10 Citations1994Hiroshi Ogawa, Masatoshi Kawana +3 more
In patients with uncomplicated AMI with 1-vessel CAD, the prognosis is relatively good and the frequency of reinfarction is very low with conservative treatment, and it was difficult to predict future progression from the outcome of the comparison between the first and second coronary arteriograms.