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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Carotid atherosclerosis progression in familial hypercholesterolemia patients: A pooled analysis of the ASAP, ENHANCE, RADIANCE 1, and CAPTIVATE studies
Circulation: Cardiovascular Imaging, Volume 3, No. 4, Year 2010
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Description
Background-Until recently, patients with heterozygous familial hypercholesterolemia (HeFH) were considered the best subjects for the assessment of changes in carotid intima-media thickness (cIMT) in randomized intervention trials. Our aims were to investigate whether contemporary statin-treated HeFH patients still show accelerated cIMT increase and to assess the impact of statin treatment, before and after random assignment, on atherosclerosis progression. Methods and Results-We retrospectively evaluated cIMT change, and prior statin treatment and postbaseline LDL-C change as predictors of cIMT change, in 1513 HeFH patients who were randomly assigned to the statin arms of the early ASAP and more recent RADIANCE 1, CAPTIVATE, and ENHANCE studies. In the 3 recent studies combined, mean cIMT increased at only 33% of the rate of the simvastatin-treated patients in the ASAP study (0.014 mm/2 years [95% confidence interval, -0.0003- 0.028] versus 0.041 mm/2 years [95% confidence interval, 0.020-0.061]; P<0.05). Patients whose statin therapy could be intensified, as evidenced by an LDL-C decrease after the initiation of on-trial statin therapy, showed cIMT decrease in the first 6 to 12 months and a much lower cIMT increase measured over the full 2 years. In line with this, previously statin-naive HeFH patients showed a lower overall cIMT increase. Conclusions-Over the years, intensification of statin therapy in HeFH patients has resulted in an impressive decrease in carotid atherosclerosis progression. In studies that assess other antiatherosclerotic modalities, statin therapy may still induce rapid changes in cIMT. For future cIMT studies, our analyses suggest that patient populations other than intensively pretreated HeFH patients should be selected and that the statin regimen should not be changed on study initiation. © 2010 American Heart Association, Inc.
Authors & Co-Authors
Vergeer, Menno
Unknown Affiliation
Zhou, Rong
Unknown Affiliation
Bots, Michiel L.
Unknown Affiliation
Duivenvoorden, Raphaël
Unknown Affiliation
Koglin, Joerg
Unknown Affiliation
Akdim, Fatima
Unknown Affiliation
Mitchel, Yale B.
Unknown Affiliation
Huijgen, Roeland
Unknown Affiliation
Sapre, Aditi
Unknown Affiliation
de Groot, Eric E.
Unknown Affiliation
Sijbrands, Eric J.G.
Unknown Affiliation
Pasternak, Richard C.
Unknown Affiliation
Gagné, Claudé E.
Unknown Affiliation
Marais, Adrian David
Unknown Affiliation
Ballantyne, Christie Mitchell
Unknown Affiliation
Isaacsohn, Jonathan L.
Unknown Affiliation
Stalenhóef, Anton F.H.
Unknown Affiliation
Kastelein, Johannes Jacob Pieter
Unknown Affiliation
Statistics
Citations: 22
Authors: 18
Affiliations: 10
Identifiers
Doi:
10.1161/CIRCIMAGING.109.909655
ISSN:
19419651
Research Areas
Genetics And Genomics
Health System And Policy
Study Design
Randomised Control Trial