Atherosclerosis intervention trials

Ericsson, C.G., J. Nilsson, L. Grip, B. Svane, and A. Hamsten. 1997. Effect of bezafibrate treatment over flve years on coronary plaques causing 20% to 50% diameter narrowing (the Bezaflbrate Coronary Atherosclerosis Intervention Trial [BECATT]). Jaun ofCaMola 1125-9. 

Waters D, Higginson L, Gladstone P, Kimball B, LeMay M, Bocuzzi SJ, et al. Atherosclerosis in coronary heart disease effects of monotherapy with an HMGCoA reductase inhibitor on the progression of coronary atherosclerosis as assessed by serial quantitative arteriography the Canadian Coronary Atherosclerosis Intervention Trial. Circulation 1994 89 959-968. 

Waters D, Lesperance J, Gladstone P, Boccuzzi SJ, Cook T, Hudgin R, et al. Effects of cigarette smoking on the angiographic evolution of coronary atherosclerosis. A Canadian Coronary Atherosclerosis Intervention Trial (CCAIT) Substudy. CCATT Study Group. Circulation 19% 94 614-621. 

Ericsson CG. Results of the Bezafibrate Coronary Atherosclerosis Intervention Trial (BECAIT) and an update on trials now in progress. Eur Heart J 1998 19 H37-H41. 

Multiple angiographic trials with fibrates have demonstrated the ability of these drugs to reduce rates of atheromatous plaque progression. The Bezafibrate Coronary Atherosclerosis Intervention Trial (BEC AIT)... 

K. F. Gey, Prevention of Early Stages of Cardiovascular Disease and Cancer May Require Concurent Optimization of All Major Antioxidants and Otiier Nutrients An Update and Reevaluation of Observational Data and Intervention Trials. In G. Bellomo, E. Maggi, and C. Rice-Evans (eds.). Free Radicals, Lipoprotein Oxidation and Atherosclerosis. Richeliu Press, London 1995. 

The n-3 LC-PUFA have a beneficial effect on plasma triglycerides, high blood pressure, whole-blood viscosity, and platelet function they inhibit the expression of cell-adhesion molecules, shift the eicosanoid profile to one of lesser thrombotic and inflammatory potential, improve vessel-wall compliance, and have antiarrhythmic potential (1,2). A number of intervention trials have associated the consumption of fish with decreased mortality from CVD (3-5). High doses of fish oil eliminate both vascular thrombus as well as vascular lesion formation (6). In men who had had a recent myocardial infarction, low-dose dietary supplementation with n-3 LC-PUFA, in addition to the recommended secondary prevention treatments, reduced by 45% the risk of sudden cardiac death, but not the risk of nonfatal myocardial infarction (7). It has been shown to mitigate the course of coronary atherosclerosis in humans (8). 

Cardiovascular disease (CVD) remains the most important cause of morbidity and mortality in people with diabetes [1], This high-risk population is more likely to suffer a fatal event as the first manifestation of myocardial infarction (MI) or stroke, making primary prevention a priority. The pathogenesis of atherosclerosis-related disease is multifactorial but dyslipidaemia is a common and important risk predictor and is open to therapeutic intervention. Pharmacological intervention is supported by major randomised, controlled clinical trials (RCTs) of primary and secondary CVD prevention. RCTs with statin drugs have demonstrated unequivocal benefit in reducing major coronary events and stroke. 

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