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A 4-Year Follow-up

Linda Cashin-Hemphill, MD; Wendy J. Mack, PhD; Janice M. Pogoda, MS; Miguel E. Sanmarco, MD; Stanley P. Azen, PhD; David H. Blankenhorn, MD

JAMA. 1990;264(23):3013-3017.

Abstract
The Cholesterol Lowering Atherosclerosis Study (CLAS) was a randomized, placebo-controlled, angiographic trial testing combined colestipol-niacin therapy in 162 subjects. Two-year results (CLAS-I) showed decreased atherosclerosis progression and increased regression. We now describe a subgroup of 103 subjects treated for 4 years (CLAS-II). Changes in blood lipid, lipoproteincholesterol, and apolipoprotein levels were maintained, and at 4 years significantly more drug-treated subjects demonstrated nonprogression (52% drug- vs 15% placebo-treated) and regression (18% drug- vs 6% placebo-treated) in native coronary artery lesions. Significantly fewer drug-treated subjects developed new lesions in native coronary arteries (14% drug- vs 40% placebo-treated) and bypass grafts (16% drug- vs 38% placebo-treated). These results confirm CLAS-I findings and indicate that regression can continue for 4 years. They reaffirm the need for early initiation of vigorous long-term lipid lowering therapy in coronary bypass subjects.

(JAMA. 1990;264:3013-3017)

Author Affiliations
From the Departments of Medicine (Drs Cashin-Hemphill, Sanmarco, and Blankenhorn) and Preventive Medicine (Drs Mack and Azen and Ms Pogoda), Atherosclerosis Research Institute, University of Southern California, Los Angeles.

Footnotes
Reprint requests to University of Southern California School of Medicine, 2025 Zonal Ave, RMR 102, Los Angeles, CA 90033 (Dr Blankenhorn).

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