Circulation, Vol 87, 1781-1791, Copyright © 1993 by American Heart Association
BG Brown, XQ Zhao, DE Sacco and JJ Albers
The consensus of evidence from angiographic trials demonstrates both
coronary artery and clinical benefits from lowering of lipids by a variety
of regimens. The findings of reduced arterial disease progression and
increased regression have been convincing but, at best, modest in their
magnitude. For example, among those treated intensively in FATS, the mean
improvement in proximal stenosis severity per patient was < 1% stenosis,
and only 12% of all lesions showed convincing regression. In view of these
modest arterial benefits, the associated reductions in cardiovascular
events have been surprisingly great. For example, coronary events were
reduced 75% in FATS; this was entirely a result of a 93% reduction in the
likelihood that a mildly or moderately diseased arterial segment would
experience substantial progression to a severe lesion at the time of a
clinical event. We believe that the magnitude of the clinical benefit is
best explained in terms of this observation, according to the following
lines of reasoning. Clinical events most commonly spring from lesions that
are initially of mild or moderate severity and then abruptly undergo a
disruptive transformation to a severe culprit lesion. The process of plaque
fissuring, leading to plaque disruption and thrombosis, triggers most
clinical coronary events. Fissuring is predicted by a large accumulation of
core lipid in the plaque and by a high density of lipid-laden macrophages
in its thinned fibrous cap. Lesions with these characteristics constitute
only 10-20% of the overall lesion population but account for 80-90% of the
acute clinical events. In the experimental setting, normalization of an
atherogenic lipid profile substantially decreases the number of lipid-
laden intimal macrophages (foam cells) and depletes cholesterol from the
core lipid pool. In the clinical setting, intensive lipid lowering
virtually halts the progression of mild and moderate lesions to clinical
events. Thus, the reduction in clinical events observed in these trials
appears to be best explained by the relation of the lipid and foam cell
content of the plaque to its likelihood of fissuring and by the effects of
lipid-lowering therapy on these "high-risk" features of plaque morphology.
The composite of data presented here supports the hypothesis that
lipid-lowering therapy selectively depletes (regresses) that relatively
small but dangerous subgroup of fatty lesions containing a large lipid core
and dense clusters of intimal macrophages. By doing so, these lesions are
effectively stabilized and clinical event rate is accordingly decreased.
ARTICLES
Lipid lowering and plaque regression. New insights into prevention of plaque disruption and clinical events in coronary disease
Department of Medicine, University of Washington School of Medicine, Seattle.
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|
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|
|
|
|
|
References Circulation, December 17, 2002; 106(25): 3373 - 3421. [Full Text]
|
|
|
|
|
|
L. G. Bucciarelli, T. Wendt, W. Qu, Y. Lu, E. Lalla, L. L. Rong, M. T. Goova, B. Moser, T. Kislinger, D. C. Lee, et al. RAGE Blockade Stabilizes Established Atherosclerosis in Diabetic Apolipoprotein E-Null Mice Circulation, November 26, 2002; 106(22): 2827 - 2835. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Mason, Z. Ahmed, R. Mankoff, E. A. Lidington, S. Ahmad, V. Bhatia, A. Kinderlerer, A. M. Randi, and D. O. Haskard Statin-Induced Expression of Decay-Accelerating Factor Protects Vascular Endothelium Against Complement-Mediated Injury Circ. Res., October 18, 2002; 91(8): 696 - 703. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. G. Brown, M. C. Cheung, A. C. Lee, X.-Q. Zhao, and A. Chait Antioxidant Vitamins and Lipid Therapy: End of a Long Romance? Arterioscler Thromb Vasc Biol, October 1, 2002; 22(10): 1535 - 1546. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Verhamme, R. Quarck, H. Hao, M. Knaapen, S. Dymarkowski, H. Bernar, J. Van Cleemput, S. Janssens, J. Vermylen, G. Gabbiani, et al. Dietary cholesterol withdrawal reduces vascular inflammation and induces coronary plaque stabilization in miniature pigs Cardiovasc Res, October 1, 2002; 56(1): 135 - 144. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J. Ryan The Coronary Angiogram and Its Seminal Contributions to Cardiovascular Medicine Over Five Decades Circulation, August 6, 2002; 106(6): 752 - 756. [Full Text] [PDF]
|
|
|
|
|
|
M. Kawasaki, H. Takatsu, T. Noda, K. Sano, Y. Ito, K. Hayakawa, K. Tsuchiya, M. Arai, K. Nishigaki, G. Takemura, et al. In Vivo Quantitative Tissue Characterization of Human Coronary Arterial Plaques by Use of Integrated Backscatter Intravascular Ultrasound and Comparison With Angioscopic Findings Circulation, May 28, 2002; 105(21): 2487 - 2492. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Ambrose and E. E. Martinez A New Paradigm for Plaque Stabilization Circulation, April 23, 2002; 105(16): 2000 - 2004. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Baetta, M. Camera, C. Comparato, C. Altana, M. D. Ezekowitz, and E. Tremoli Fluvastatin Reduces Tissue Factor Expression and Macrophage Accumulation in Carotid Lesions of Cholesterol-Fed Rabbits in the Absence of Lipid Lowering Arterioscler Thromb Vasc Biol, April 1, 2002; 22(4): 692 - 698. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Sawayama, C. Shimizu, N. Maeda, M. Tatsukawa, N. Kinukawa, S. Koyanagi, S. Kashiwagi, and J. Hayashi Effects of probucol and pravastatin on common carotid atherosclerosis in patients with asymptomatic hypercholesterolemia: Fukuoka atherosclerosis trial (FAST) J. Am. Coll. Cardiol., February 20, 2002; 39(4): 610 - 616. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. E. Feeman Jr, L. R. Caldwell, D. Iliff, P. J. Rosch, B. L. Ring, S. M. Grundy, and J. I. Cleeman Guidelines for Diagnosis and Treatment of High Cholesterol JAMA, November 21, 2001; 286(19): 2400 - 2402. [Full Text] [PDF]
|
|
|
|
|
|
M. Takemoto and J. K. Liao Pleiotropic Effects of 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors Arterioscler Thromb Vasc Biol, November 1, 2001; 21(11): 1712 - 1719. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X.-Q. Zhao, C. Yuan, T. S. Hatsukami, E. H. Frechette, X.-J. Kang, K. R. Maravilla, and B. G. Brown Effects of Prolonged Intensive Lipid-Lowering Therapy on the Characteristics of Carotid Atherosclerotic Plaques In Vivo by MRI: A Case-Control Study Arterioscler Thromb Vasc Biol, October 1, 2001; 21(10): 1623 - 1629. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Schartl, W. Bocksch, D. H. Koschyk, W. Voelker, K. R. Karsch, J. Kreuzer, D. Hausmann, S. Beckmann, and M. Gross Use of Intravascular Ultrasound to Compare Effects of Different Strategies of Lipid-Lowering Therapy on Plaque Volume and Composition in Patients With Coronary Artery Disease Circulation, July 24, 2001; 104(4): 387 - 392. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Corti, Z. A. Fayad, V. Fuster, S. G. Worthley, G. Helft, J. Chesebro, M. Mercuri, and J. J. Badimon Effects of Lipid-Lowering by Simvastatin on Human Atherosclerotic Lesions: A Longitudinal Study by High-Resolution, Noninvasive Magnetic Resonance Imaging Circulation, July 17, 2001; 104(3): 249 - 252. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. K. Thakur, T. Hayashi, D. Sumi, H. Kano, T. Tsunekawa, and A. Iguchi HMG-CoA reductase inhibitor stabilizes rabbit atheroma by increasing basal NO and decreasing superoxide Am J Physiol Heart Circ Physiol, July 1, 2001; 281(1): H75 - H83. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. K. Ito, G. M. Delucca, and M. A. Aldridge The Relationship Between Low-Density Lipoprotein Cholesterol Goal Attainment and Prevention of Coronary Heart Disease-Related Events Journal of Cardiovascular Pharmacology and Therapeutics, June 1, 2001; 6(2): 129 - 135. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Aikawa and P. Libby Vascular inflammation and activation: new targets for lipid lowering Eur. Heart J. Suppl., May 1, 2001; 3(suppl_B): B3 - B11. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Bellosta, M. Canavesi, E. Favari, L. Cominacini, G. Gaviraghi, R. Fumagalli, R. Paoletti, and F. Bernini Lalsoacidipine Modulates the Secretion of Matrix Metalloproteinase-9 by Human Macrophages J. Pharmacol. Exp. Ther., March 1, 2001; 296(3): 736 - 743. [Abstract] [Full Text]
|
|
|
|
|
|
Y. Fukumoto, P. Libby, E. Rabkin, C. C. Hill, M. Enomoto, Y. Hirouchi, M. Shiomi, and M. Aikawa Statins Alter Smooth Muscle Cell Accumulation and Collagen Content in Established Atheroma of Watanabe Heritable Hyperlipidemic Rabbits Circulation, February 20, 2001; 103(7): 993 - 999. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. B. Hu, J. E. Manson, and W. C. Willett Types of Dietary Fat and Risk of Coronary Heart Disease: A Critical Review J. Am. Coll. Nutr., February 1, 2001; 20(1): 5 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sdringola, D. Patel, and K. L. Gould High Prevalence of Myocardial Perfusion Abnormalities on Positron Emission Tomography in Asymptomatic Persons With a Parent or Sibling With Coronary Artery Disease Circulation, January 30, 2001; 103(4): 496 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Aikawa, E. Rabkin, S. Sugiyama, S. J. Voglic, Y. Fukumoto, Y. Furukawa, M. Shiomi, F. J. Schoen, and P. Libby An HMG-CoA Reductase Inhibitor, Cerivastatin, Suppresses Growth of Macrophages Expressing Matrix Metalloproteinases and Tissue Factor In Vivo and In Vitro Circulation, January 16, 2001; 103(2): 276 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Stevenson, M. Flather, P. Collins, N. P. Assefi, C. S. Rhoads, M. Bassan, P. W. Anderson, E. Moscarelli, D. M. Herrington, D. Waters, et al. Coronary Heart Disease in Women N. Engl. J. Med., December 21, 2000; 343(25): 1891 - 1894. [Full Text]
|
|
|
|
|
|
K. K. Teo, J. R. Burton, C. E. Buller, S. Plante, D. Catellier, W. Tymchak, V. Dzavik, D. Taylor, S. Yokoyama, and T. J. Montague Long-Term Effects of Cholesterol Lowering and Angiotensin-Converting Enzyme Inhibition on Coronary Atherosclerosis : The Simvastatin/Enalapril Coronary Atherosclerosis Trial (SCAT) Circulation, October 10, 2000; 102(15): 1748 - 1754. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Houghton, T. A. Pearson, R. G. Reed, M. T. Torosoff, N. L. Henches, P. A. Kuhner, and E. F. Philbin Cholesterol Lowering With Pravastatin Improves Resistance Artery Endothelial Function : Report of Six Subjects With Normal Coronary Arteriograms Chest, September 1, 2000; 118(3): 756 - 760. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. G. Nabel Coronary Heart Disease in Women -- An Ounce of Prevention N. Engl. J. Med., August 24, 2000; 343(8): 572 - 574. [Full Text]
|
|
|
|
 |
|
 S. M. Grundy Cholesterol-Lowering Therapy in Secondary Prevention: Remaining Issues J. Clin. Endocrinol. Metab., June 1, 2000; 85(6): 2092 - 2098. [Full Text]
|
|
|
|
|
|
C. P. M. Leeson, P. H. Whincup, D. G. Cook, M. J. Mullen, A. E. Donald, C. A. Seymour, and J. E. Deanfield Cholesterol and Arterial Distensibility in the First Decade of Life : A Population-Based Study Circulation, April 4, 2000; 101(13): 1533 - 1538. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Suwaidi, S. Hamasaki, S. T. Higano, R. A. Nishimura, D. R. Holmes Jr, and A. Lerman Long-Term Follow-Up of Patients With Mild Coronary Artery Disease and Endothelial Dysfunction Circulation, March 7, 2000; 101(9): 948 - 954. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Hamasaki, S. T. Higano, J. A. Suwaidi, R. A. Nishimura, K. Miyauchi, D. R. Holmes Jr, and A. Lerman Cholesterol-Lowering Treatment Is Associated With Improvement in Coronary Vascular Remodeling and Endothelial Function in Patients With Normal or Mildly Diseased Coronary Arteries Arterioscler Thromb Vasc Biol, March 1, 2000; 20(3): 737 - 743. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R A Coulden, H Moss, M J Graves, D J Lomas, D S Appleton, and P L Weissberg High resolution magnetic resonance imaging of atherosclerosis and the response to balloon angioplasty Heart, February 1, 2000; 83(2): 188 - 191. [Abstract] [Full Text]
|
|
|
|
|
|
C. J. Vaughan, A. M. Gotto Jr., and C. T. Basson The evolving role of statins in the management of atherosclerosis J. Am. Coll. Cardiol., January 1, 2000; 35(1): 1 - 10. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Joakimsen, K. H. Bonaa, E. Stensland-Bugge, and B. K. Jacobsen Age and Sex Differences in the Distribution and Ultrasound Morphology of Carotid Atherosclerosis : The Tromso Study Arterioscler Thromb Vasc Biol, December 1, 1999; 19(12): 3007 - 3013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Aikawa, S. J. Voglic, S. Sugiyama, E. Rabkin, M. B. Taubman, J. T. Fallon, and P. Libby Dietary Lipid Lowering Reduces Tissue Factor Expression in Rabbit Atheroma Circulation, September 14, 1999; 100(11): 1215 - 1222. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Tsukamoto, R. Tangirala, S. H. Chun, E. Pure, and D. J. Rader Rapid Regression of Atherosclerosis Induced by Liver-Directed Gene Transfer of ApoE in ApoE-Deficient Mice Arterioscler Thromb Vasc Biol, September 1, 1999; 19(9): 2162 - 2170. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. M. Psaty, N. S. Weiss, C. D. Furberg, T. D. Koepsell, D. S. Siscovick, F. R. Rosendaal, N. L. Smith, S. R. Heckbert, R. C. Kaplan, D. Lin, et al. Surrogate End Points, Health Outcomes, and the Drug-Approval Process for the Treatment of Risk Factors for Cardiovascular Disease JAMA, August 25, 1999; 282(8): 786 - 790. [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Grundy, J. I. Cleeman, B. M. Rifkind, L. H. Kuller, and for the Coordinating Committee of the National Cho Cholesterol Lowering in the Elderly Population Arch Intern Med, August 9, 1999; 159(15): 1670 - 1678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Waters Cholesterol Lowering : Should It Continue to Be the Last Thing We Do? Circulation, June 29, 1999; 99(25): 3215 - 3217. [Full Text] [PDF]
|
|
|
|
|
|
T. Sheth, C. Nair, J. Muller, and S. Yusuf Increased winter mortality from acute myocardial infarction and stroke: the effect of age J. Am. Coll. Cardiol., June 1, 1999; 33(7): 1916 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Dangas, J. J. Badimon, D. A. Smith, A. H. Unger, D. Levine, J. H. Shao, P. Meraj, C. Fier, J. T. Fallon, and J. A. Ambrose Pravastatin therapy in hyperlipidemia: effects on thrombus formation and the systemic hemostatic profile J. Am. Coll. Cardiol., April 1, 1999; 33(5): 1294 - 1304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Gotto Jr and S. M. Grundy Lowering LDL Cholesterol : Questions From Recent Meta-Analyses and Subset Analyses of Clinical Trial DataIssues From the Interdisciplinary Council on Reducing the Risk for Coronary Heart Disease, Ninth Council Meeting Circulation, March 2, 1999; 99 (8): e1 - e7. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. G. Zimmermann-Paul, H. H. Quick, P. Vogt, G. K. von Schulthess, D. Kling, and J. F. Debatin High-Resolution Intravascular Magnetic Resonance Imaging : Monitoring of Plaque Formation in Heritable Hyperlipidemic Rabbits Circulation, March 2, 1999; 99(8): 1054 - 1061. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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R. J. Bache Vasodilator Reserve : A Functional Assessment of Coronary Health Circulation, September 29, 1998; 98(13): 1257 - 1260. [Full Text] [PDF]
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G. S. Huggins, R. C. Pasternak, N. M. Alpert, A. J. Fischman, and H. Gewirtz Effects of Short-Term Treatment of Hyperlipidemia on Coronary Vasodilator Function and Myocardial Perfusion in Regions Having Substantial Impairment of Baseline Dilator Reverse Circulation, September 29, 1998; 98(13): 1291 - 1296. [Abstract] [Full Text] [PDF]
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T. Neunteufl, K. Kostner, R. Katzenschlager, M. Zehetgruber, G. Maurer, and F. Weidinger Additional benefit of vitamin E supplementation to simvastatin therapy on vasoreactivity of the brachial artery of hypercholesterolemic men J. Am. Coll. Cardiol., September 1, 1998; 32(3): 711 - 716. [Abstract] [Full Text] [PDF]
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P. K Shah Role of inflammation and metalloproteinases in plaque disruption and thrombosis Vascular Medicine, August 1, 1998; 3(3): 199 - 206. [Abstract] [PDF]
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V. Fuster, J. J. Badimon, and J. H Chesebro Atherothrombosis: mechanisms and clinical therapeutic approaches Vascular Medicine, August 1, 1998; 3(3): 231 - 239. [Abstract] [PDF]
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 J. K. Liao Endothelium and acute coronary syndromes Clin. Chem., August 1, 1998; 44(8): 1799 - 1808. [Abstract] [Full Text] [PDF]
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W. Stanford and B. H. Thompson Coronary atherosclerosis and its effect on cardiac structure and function: evaluation by electron beam computed tomography Clin. Chem., August 1, 1998; 44(8): 1871 - 1881. [Abstract] [Full Text] [PDF]
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M. Aikawa, E. Rabkin, Y. Okada, S. J. Voglic, S. K. Clinton, C. E. Brinckerhoff, G. K. Sukhova, and P. Libby Lipid Lowering by Diet Reduces Matrix Metalloproteinase Activity and Increases Collagen Content of Rabbit Atheroma : A Potential Mechanism of Lesion Stabilization Circulation, June 23, 1998; 97(24): 2433 - 2444. [Abstract] [Full Text] [PDF]
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 E. Delacrétaz, P. G Michalopoulos, J. Ruiz, H. Saner, and B. Meier Management of hyperlipidaemia after coronary revascularisation: follow up study BMJ, May 16, 1998; 316(7143): 1499 - 1500. [Full Text]
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U. Laufs, V. La Fata, J. Plutzky, and J. K. Liao Upregulation of Endothelial Nitric Oxide Synthase by HMG CoA Reductase Inhibitors Circulation, March 31, 1998; 97(12): 1129 - 1135. [Abstract] [Full Text] [PDF]
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G. Davi, M. Romano, A. Mezzetti, A. Procopio, S. Iacobelli, T. Antidormi, T. Bucciarelli, P. Alessandrini, F. Cuccurullo, and G. B. Bon Increased Levels of Soluble P-Selectin in Hypercholesterolemic Patients Circulation, March 17, 1998; 97(10): 953 - 957. [Abstract] [Full Text] [PDF]
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A. M. Gotto Jr Cholesterol Management in Theory and Practice Circulation, December 16, 1997; 96(12): 4424 - 4430. [Abstract] [Full Text]
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C. Patrono and G. A. FitzGerald Isoprostanes: Potential Markers of Oxidant Stress in Atherothrombotic Disease Arterioscler Thromb Vasc Biol, November 1, 1997; 17(11): 2309 - 2315. [Abstract] [Full Text]
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G. Davi, P. Alessandrini, A. Mezzetti, G. Minotti, T. Bucciarelli, F. Costantini, F. Cipollone, G. B. Bon, G. Ciabattoni, and C. Patrono In Vivo Formation of 8-Epi-Prostaglandin F2{alpha} Is Increased in Hypercholesterolemia Arterioscler Thromb Vasc Biol, November 1, 1997; 17(11): 3230 - 3235. [Abstract] [Full Text]
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J. Niebauer, R. Hambrecht, T. Velich, K. Hauer, C. Marburger, B. Kalberer, C. Weiss, E. von Hodenberg, G. Schlierf, G. Schuler, et al. Attenuated Progression of Coronary Artery Disease After 6 Years of Multifactorial Risk Intervention : Role of Physical Exercise Circulation, October 21, 1997; 96(8): 2534 - 2541. [Abstract] [Full Text]
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W. V. Rodrigueza, K. D. Mazany, A. D. Essenburg, M. E. Pape, T. J. Rea, C. L. Bisgaier, and K. J. Williams Large Versus Small Unilamellar Vesicles Mediate Reverse Cholesterol Transport In Vivo Into Two Distinct Hepatic Metabolic Pools : Implications for the Treatment of Atherosclerosis Arterioscler Thromb Vasc Biol, October 1, 1997; 17(10): 2132 - 2139. [Abstract] [Full Text]
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M. D. Guazzi, M. Bussotti, L. Grancini, N. De Cesare, M. Guazzi, I. L. Pera, and A. Loaldi Evidence of Multifocal Activity of Coronary Disease in Patients With Acute Myocardial Infarction Circulation, August 19, 1997; 96(4): 1145 - 1151. [Abstract] [Full Text]
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C. Yuan, C. Petty, K. D. O'Brien, T. S. Hatsukami, J. F. Eary, and B. G. Brown In Vitro and In Situ Magnetic Resonance Imaging Signal Features of Atherosclerotic Plaque-Associated Lipids Arterioscler Thromb Vasc Biol, August 1, 1997; 17(8): 1496 - 1503. [Abstract] [Full Text]
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W. R. M. Aengevaeren, G. J. H. Uijen, J. W. Jukema, A. V. G. Bruschke, and T. van der Werf Functional Evaluation of Lipid-Lowering Therapy by Pravastatin in the Regression Growth Evaluation Statin Study (REGRESS) Circulation, July 15, 1997; 96(2): 429 - 435. [Abstract] [Full Text]
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J. R. Crouse III, R. P. Byington, H. M. Hoen, and C. D. Furberg Reductase Inhibitor Monotherapy and Stroke Prevention Arch Intern Med, June 23, 1997; 157(12): 1305 - 1310. [Abstract] [PDF]
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S. M. Grundy Cholesterol and Coronary Heart Disease: The 21st Century Arch Intern Med, June 9, 1997; 157(11): 1177 - 1184. [Abstract] [PDF]
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A. P. Burke, A. Farb, G. T. Malcom, Y.-h. Liang, J. Smialek, and R. Virmani Coronary Risk Factors and Plaque Morphology in Men with Coronary Disease Who Died Suddenly N. Engl. J. Med., May 1, 1997; 336(18): 1276 - 1282. [Abstract] [Full Text] [PDF]
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P. Alaupovic, W. J. Mack, C. Knight-Gibson, and H. N. Hodis The Role of Triglyceride-Rich Lipoprotein Families in the Progression of Atherosclerotic Lesions as Determined by Sequential Coronary Angiography From a Controlled Clinical Trial Arterioscler Thromb Vasc Biol, April 1, 1997; 17(4): 715 - 722. [Abstract] [Full Text]
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S. M. Grundy, G. J. Balady, M. H. Criqui, G. Fletcher, P. Greenland, L. F. Hiratzka, N. Houston-Miller, P. Kris-Etherton, H. M. Krumholz, J. LaRosa, et al. When to Start Cholesterol-Lowering Therapy in Patients With Coronary Heart Disease : A Statement for Healthcare Professionals From the American Heart Association Task Force on Risk Reduction Circulation, March 18, 1997; 95(6): 1683 - 1685. [Full Text]
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L. K. Andersen, H. K. Jensen, S. Juul, and O. Faergeman Patients' Attitudes Toward Detection of Heterozygous Familial Hypercholesterolemia Arch Intern Med, March 10, 1997; 157(5): 553 - 560. [Abstract] [PDF]
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G. O'Driscoll, D. Green, and R. R. Taylor Simvastatin, an HMG–Coenzyme A Reductase Inhibitor, Improves Endothelial Function Within 1 Month Circulation, March 4, 1997; 95(5): 1126 - 1131. [Abstract] [Full Text]
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