Skip Navigation

European Heart Journal 1995 16(Supplement I):26-30; doi:10.1093/eurheartj/16.suppl_I.26
Copyright © 1995 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by De Feyter, P. J.
Right arrow Articles by Deckers, J. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by De Feyter, P. J.
Right arrow Articles by Deckers, J. W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1995 The European Society of Cardiology

Progression and regression of the atherosclerotic plaque

P. J. De Feyter, J. Vos and J. W. Deckers

Catheterisation Laboratory, Thoraxcenter, University Hospital Rotterdam Dijkzigt, The Netherlands

Correspondence: Pim J. de Feyter. MD, Catheterisation Laboratory, Thoraxcenter Bd 432. University Hospital Dijkzigt. Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands

In animals in which atherosclerosis was induced experimentally (by a high cholesterol diet) regression of the atherosclerotic lesion was demonstrated after serum cholesterol was reduced by cholesterol-lowering drugs or a low-fat diet. Whether regression of advanced coronary artery lesions also takes place in humans after a similar intervention remains conjectural. However, several randomized studies, primarily employing lipid-lowering intervention or comprehensive changes in lifestyle, have demonstrated, using serial angiograms, that it is possible to achieve less progression, arrest or even (small) regression of atherosclerotic lesions.

The lipid-lowering trials (NHBLI, CLAS, POSCH, FATS, SCOR and STARS) studied 1240 symptomatic patients, mostly men, with moderately elevated cholesterol levels and moderately severe angiographic-proven coronary artery disease. A variety of lipid-lowering drugs, in addition to a diet, were used over an intervention period ranging from 2 to 3 years. In all but one study (NHBLI), the progression of coronary atherosclerosis was less in the treated group, but regression was induced in only a few patients. The overall relative risk of progression of coronary atherosclerosis was 0·62 and 2·13, respectively. The induced angiographic differences were small and did not produce any significant haemodynamic benefit. The most important result was that the disease process could be stabilized in the majority of patients. Three comprehensive lifestyle change trials (the Lifestyle Heart Study, STARS and the Heidelberg Study) studied 183 patients, who were subjected to stress management, and/or intensive exercise, in addition to a low fat diet, over a period ranging from 1 to 3 years. All three trials demonstrated less progression, and more regression with overall relative risks of 0·40 and 2·35 respectively, in the intervention groups.

Angiographic trials demonstrated that retardation or arrest of coronary atherosclerosis was possible after an intervention, but the ultimate goal, regression of the lesion, was only achieved in a small number of patients. However, the ability to stabilize coronary atherosclerosis is a considerable achievement for those patients with coronary atherosclerosis.

Key Words: Atherosclerosis • progression/regression • coronary angiography • cholestrol-lowering drugs


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.