aha2003：ldl和hdl对粥瘤影响.pptVIP

ApoA-1 Milano: Conclusions Some regression of atherosclerosis after five weeks of ETC-216 infusion Very fascinating HDL may halt the progression of atherosclerotic disease by helping the artery to get rid of the excess oxidized LDL Fuster ApoA-1 Milano: The HDL question REVERSALPutting icing on a cake that we already have. This work is pioneering, because it will get into the HDL question. HDL known to be associated with CAD Prevention of atherosclerosis by affecting HDL has been questioned Grundy ApoA-1 Milano: End points Different calculations of the primary end point in the two trials Agent % change in total atheroma volume Pravastatin +2.7 Atorvastatin -0.4 ApoA-1 Milano -4.2 ApoA-1 Milano: Drastic changes Effectively, we saw the elimination of a couple of years worth of progression. We were just shocked when the statisticians delivered the data. Large changes in big fatty plaques Nissen Heartbeat – Dec 2003 AHA 2003 * * * * AHA 2003: Tackling LDL and HDL for atheroma regression Valentin Fuster MD Director, Cardiovascular Institute Mount Sinai Medical Center New York, NY Steve Nissen MD Professor of Medicine Cleveland Clinic Foundation Cleveland, OH Scott Grundy MD Director, Center for Human Nutrition UT Southwestern Medical Center Dallas, TX REVERSALEffects of atorvastatin vs pravastatin on atherosclerosis progression ApoA-1 Milano Effect of an HDL mimic on atherosclerosis progression Topics REVERSing Atherosclerosis with Lipitor REVERSAL REVERSAL: Design 654 patients randomized at 24 US centers, with indication for atherosclerotic disease, stenosis of 20%, and LDL levels between 125 and 210 mg/dL Intensive atorvastatin (80 mg daily) vs moderate pravastatin (40 mg daily) therapy Primary end point: percent change in coronary plaque volume, as measured by IVUS between baseline and 18 months Outcome Pravastatin (n=249) Atorvastatin (n=253) p Final LDL level 110 79 0.001 % change in atheroma volume +2.7 (