Effect of Torcetrapib on Carotid Atherosclerosis in Familial Hypercholesterolemia  

Oleh:

Kastelein, John J.P ; Leuven, Sander I Van ; Burgess, Leslie ; Evans, Greg W ; Kuivenhoven, Jan A ; Barter, Philip J. ; Revkin, James H. ; Grobbee, Diederick E. ; Riley, Ward A. ; Shear, Charles L. ; Duggan, William T.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 356 no. 16 (Apr. 2007), page 1620.

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2007.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

METHODS A total of 850 patients with heterozygous familial hypercholesterolemia underwent B-mode ultrasonography at baseline and at follow-up to measure changes in carotid intima-media thickness. The patients completed an atorvastatin run-in period and were subsequently randomly assigned to receive either atorvastatin monotherapy or atorvastatin combined with 60 mg of torcetrapib for 2 years. RESULTS After 24 months, in the atorvastatin-only group, the mean (+SD) HDL cholesterol level was 52.4::t13.5 mg per deciliter and the mean low-density lipoprotein (LDL) cholesterol level was 143.2::t42.2 mg per deciliter, as compared with 81.5::t22.6 mg per deciliter and 115.1::t48.5 mg per deciliter, respectively, in the torcetrapib-atorvastatin group. During the study, average systolic blood pressure increased by 2.8 mm Hg in the torcetrapib-atorvastatin group, as compared with the atorvastatin only group. The increase in maximum carotid intima-media thickness, the primary measure of efficacy, was 0.0053::tO.0028 mm per year in the atorvastatin-only group and 0.0047::tO.0028 mm per year in the torcetrapib-atorvastatin group (P=0.87). The secondary efficacy measure, annualized change in mean carotid intima-media thickness for the common carotid artery, indicated a decrease of 0.0014 mm per year in the atorvastatin-only group, as compared with an increase of 0.0038 mm per year in the torcetrapib-atorvastatin group (P=0.005). CONCLUSIONS In patients with familial hypercholesterolemia, the use of torcetrapib with atorvastatin, as compared with atorvastatin alone, did not result in further reduction of progression of atherosclerosis, as assessed by a combined measure of carotid arterial-wall thickness, and was associated with progression of disease in the common carotid segment. These effects occurred despite a large increase in HDL cholesterol levels and a substantial decrease in levels of LDL cholesterol and triglycerides. (ClinicaITrials.gov number, NCTOO136981)

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