Beneficial Effects of Combined Colestipol-Niacin Therapy on Coronary Atherosclerosis and Coronary Venous Bypass Grafts
- David H. Blankenhorn, MD;
- Sharon A. Nessim, DrPH;
- Ruth L. Johnson, RD, MA;
- Miguel E. Sanmarco, MD;
- Stanley P. Azen, PhD;
- Linda Cashin-Hemphill, MD
Abstract
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. During two years of treatment there was a 26% reduction in total plasma cholesterol, a 43% reduction in low-density lipoprotein cholesterol, plus a simultaneous 37% elevation of high-density lipoprotein cholesterol. This resulted in a significant reduction in the average number of lesions per subject that progressed (P<.03) and the percentage of subjects with new atheroma formation (P<.03) in native coronary arteries. Also, the percentage of subjects with new lesions (P<.04) or any adverse change in bypass grafts (P<.03) was significantly reduced. Deterioration in overall coronary status was significantly less in drug-treated subjects than placebo-treated subjects (P<.001). Atherosclerosis regression, as indicated by perceptible improvement in overall coronary status, occurred in 16.2% of colestipol-niacin treated vs 2.4% placebo treated (P =.002).
(JAMA 1987;257:3233-3240)
Footnotes
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Reprint requests to the Department of Medicine, Atherosclerosis Research, University of Southern California, 2025 Zonal Ave, Los Angeles, CA 90033 (Dr Blankenhorn).
