A CONTROLLED TRIAL TO REVERSE CORONARY ATHEROSCLEROSIS

逆转冠状动脉粥样硬化的对照试验

• 批准号: 3351375
• 负责人: FRANK M SACKS
• 金额: $ 38.69万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1986
• 资助国家: 美国
• 起止时间: 1986-12-01 至 1991-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3351375
• 关键词: angiography; antihypercholesterolemic agent; apolipoproteins; artery stenosis; atherosclerosis; cardiovascular disorder epidemiology; cardiovascular disorder prevention; computer assisted diagnosis; coronary bypass; coronary disorder; diet therapy; dietary carbohydrates; dietary fiber; dietary lipid; high density lipoproteins; human subject; hypercholesterolemia; longitudinal human study; low density lipoprotein; marine animal oil

The prognosis of patients with coronary heart disease (CHD) is closely related to the degree of coronary luminal obstruction. In population studies, the incidence and severity of coronary atherosclerosis on arteriography is correlated with diet and plasma lipoprotein cholesterol. The proposed investigation will test directly by sequential coronary arteriography whether an intensive hypolipidemic program of diet with and without drugs can reverse or retard the progression of obstructive coronary artery disease in humans. The effect of therapy will be studied in 90 normolipidemic patients who will have received medical treatment for their coronary disease and in 90 patients who will have received saphenous vein coronary artery bypass grafts. Therefore, the effect of therapy will be determined in native coronary arteries that are in a native coronary circulation and that are in a circulation that has received aortocoronary bypass grafts. The potential benefit of treatment on stenosis in the bypass grafts also will be studied. Patients will be eligible for the study who have significance stenoses in one or more major coronary arteries on angiography, and who have plasma cholesterol levels below 250 mg/dl. Patients will be randomized into three groups: 1) standard dietary advice only, 2) an intensive dietary program, 3) the intensive diet plus hypolipidemic drugs as needed to lower plasma total cholesterol to 160mg/dl or LDL-cholesterol to 105mg/dl. After 24 months of therapy, a second coronary arteriogram will be performed. Computerized densitometric analysis of the pre- and post-treatment angiograms will quantitate the change over two years of therapy in minimum diameter of stenosed coronary arterial segments. The technique will also quantitate the change in mean diameter of coronary arteries that are visually normal. The precision of the technique will enable the study to detect a mean change of less than 10% in arterial luminal size.

冠心病（CHD）患者的预后密切 与冠状动脉腔障碍的程度有关。 人口 研究，冠状动脉粥样硬化的发病率和严重程度 动脉造影与饮食和血浆脂蛋白胆固醇相关。 提出的研究将直接通过顺序冠状动脉进行测试 动脉摄影是否与饮食的强化降低降低饮食计划和 没有药物可以逆转或阻碍阻塞性冠状动脉的进展 人类动脉疾病。 将研究治疗的作用 将因其冠状动脉疾病而接受医学治疗 将接受隐性静脉冠状动脉搭桥的患者 移植物。 因此，治疗的作用将在天然中确定 冠状动脉循环中的冠状动脉 接收主动脉旁路移植物的循环。 潜力 还将研究旁路移植物中狭窄的益处。 患者将有资格参加在研究中具有重要意义的研究 血管造影的一个或多个主要冠状动脉，并且具有等离子体 胆固醇水平低于250 mg/dl。 患者将被随机分为三个 组：1）仅标准饮食建议，2）一个密集的饮食计划， 3）根据需要降低血浆的密集饮食加上降血糖药 总胆固醇至160mg/dL或LDL-胆固醇至105mg/dl。 24之后 几个月的治疗，将进行第二次冠状动脉造影。 处理前和治疗的计算机密度分析 血管造影将在两年的治疗中量化最少的变化 炎症冠状动脉片段的直径。 该技术也将 定量冠状动脉平均直径的变化 视觉正常。 该技术的精度将使研究能够 检测平均变化小于10％的动脉腔尺寸。