Beneficial Effects of Colestipol-Niacin on Coronary Atherosclerosis
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
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)
Footnotes
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Reprint requests to University of Southern California School of Medicine, 2025 Zonal Ave, RMR 102, Los Angeles, CA 90033 (Dr Blankenhorn).
