Circulation, Vol 88, 20-28, Copyright © 1993 by American Heart Association
DH Blankenhorn, RH Selzer, DW Crawford, JD Barth, CR Liu, CH Liu, WJ Mack and P Alaupovic
BACKGROUND. Controlled clinical trials have reported treatment effects
evaluated with serial imaging in coronary and femoral but not cervical
arteries. The Cholesterol Lowering Atherosclerosis Study, a coronary,
cervical, and femoral angiographic trial of colestipol plus niacin,
included a pilot study of standardized carotid ultrasound imaging. METHODS
AND RESULTS. Seventy-eight subjects had ultrasound studies at baseline, 2,
and 4 years. Twenty-four drug and 22 placebo subjects had carotid
ultrasound images at baseline, 2, and 4 years with matching cervical
angiograms. Computer image processing was applied to ultrasound images of
common carotid (far wall) and cervical angiograms. Computer operators were
blind to treatment group. Carotid ultrasound measurements were tested for
treatment effects and compared with measurements of atherosclerosis in
coronary and cervical angiograms. Drug subjects showed significant
progressive reduction in carotid thickness at 2 (P = .0001) and 4 years (P
= .0001); placebo subjects significantly increased wall thickness at 2 and
4 years. Reduced levels of apolipoprotein B and increased levels of high
density lipoprotein cholesterol and apolipoprotein C-III were significant
predictors of carotid wall thinning. Ultrasound-measured carotid
intima-media thickness was correlated at baseline with visually read
coronary angiographic stenosis and at 2 years with a robust computer
measurement of mild carotid atherosclerosis. CONCLUSIONS. Common carotid
intima- media thickening can be reduced by colestipol-niacin treatment.
Two- year image-processed carotid ultrasound trials can provide adequate
power with 50 subjects per group to test for this treatment effect.
ARTICLES
Beneficial effects of colestipol-niacin therapy on the common carotid artery. Two- and four-year reduction of intima-media thickness measured by ultrasound
Department of Medicine, University of Southern California, Los Angeles.
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S. Tonstad, O. Joakimsen, E. Stensland-Bugge, T. P. Leren, L. Ose, D. Russell, and K. H. Bonaa Risk Factors Related to Carotid Intima-Media Thickness and Plaque in Children With Familial Hypercholesterolemia and Control Subjects Arterioscler Thromb Vasc Biol, August 1, 1996; 16(8): 984 - 991. [Abstract] [Full Text] |
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I. Wendelhag, O. Wiklund, and J. Wikstrand On Quantifying Plaque Size and Intima-Media Thickness in Carotid and Femoral Arteries: Comments on Results From a Prospective Ultrasound Study in Patients With Familial Hypercholesterolemia Arterioscler Thromb Vasc Biol, July 1, 1996; 16(7): 843 - 850. [Abstract] [Full Text] |
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M. L. Bots, J. C. M. Witteman, A. Hofman, P. T. V. M. de Jong, and D. E. Grobbee Low Diastolic Blood Pressure and Atherosclerosis in Elderly Subjects: The Rotterdam Study Arch Intern Med, April 22, 1996; 156(8): 843 - 848. [Abstract] [PDF] |
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M. Suurkula, S. Agewall, B. Fagerberg, I. Wendelhag, and J. Wikstrand Multiple Risk Intervention in High-Risk Hypertensive Patients : A 3-Year Ultrasound Study of Intima-Media Thickness and Plaques in the Carotid Artery Arterioscler Thromb Vasc Biol, March 1, 1996; 16(3): 462 - 470. [Abstract] [Full Text] |
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M. Cortellaro, D. Baldassarre, E. Cofrancesco, E. Tremoli, A. Colombo, C. Boschetti, and R. Paoletti Relation Between Hemostatic Variables and Increase of Common Carotid Intima-Media Thickness in Patients With Peripheral Arterial Disease Stroke, March 1, 1996; 27(3): 450 - 454. [Abstract] [Full Text] |
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M. A. Espeland, T. E. Craven, W. A. Riley, J. Corson, A. Romont, and C. D. Furberg Reliability of Longitudinal Ultrasonographic Measurements of Carotid Intimal-Medial Thicknesses Stroke, March 1, 1996; 27(3): 480 - 485. [Abstract] [Full Text] |
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D. H. O'Leary, J. F. Polak, R. A. Kronmal, P. J. Savage, N. O. Borhani, S. J. Kittner, R. Tracy, J. M. Gardin, T. R. Price, and C. D. Furberg Thickening of the Carotid Wall : A Marker for Atherosclerosis in the Elderly? Stroke, February 1, 1996; 27(2): 224 - 231. [Abstract] [Full Text] |
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J. R. Crouse, U. Goldbourt, G. Evans, J. Pinsky, A. R. Sharrett, P. Sorlie, W. Riley, and G. Heiss Risk Factors and Segment-Specific Carotid Arterial Enlargement in the Atherosclerosis Risk in Communities (ARIC) Cohort Stroke, January 1, 1996; 27(1): 69 - 75. [Abstract] [Full Text] |
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M. R. Adams, A. Nakagomi, A. Keech, J. Robinson, R. McCredie, B. P. Bailey, S. B. Freedman, and D. S. Celermajer Carotid Intima-Media Thickness Is Only Weakly Correlated With the Extent and Severity of Coronary Artery Disease Circulation, October 15, 1995; 92(8): 2127 - 2134. [Abstract] [Full Text] |
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J. R. Crouse III, T. E. Craven, A. P. Hagaman, and M. G. Bond Association of Coronary Disease With Segment-Specific Intimal-Medial Thickening of the Extracranial Carotid Artery Circulation, September 1, 1995; 92(5): 1141 - 1147. [Abstract] [Full Text] |
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A. M. Gotto Jr Lipid Lowering, Regression, and Coronary Events : A Review of the Interdisciplinary Council on Lipids and Cardiovascular Risk Intervention, Seventh Council Meeting Circulation, August 1, 1995; 92(3): 646 - 656. [Full Text] |
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J. Selhub, P. F. Jacques, A. G. Bostom, R. B. D'Agostino, P. W.F. Wilson, A. J. Belanger, D. H. O'Leary, P. A. Wolf, E. J. Schaefer, and I. H. Rosenberg Association between Plasma Homocysteine Concentrations and Extracranial Carotid-Artery Stenosis N. Engl. J. Med., February 2, 1995; 332(5): 286 - 291. [Abstract] [Full Text] [PDF] |
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CHOLESTEROL REDUCTION REDUCES CAROTID-ARTERY THICKENING Journal Watch (General), July 23, 1993; 1993(723): 7 - 7. [Full Text] |
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