HATS

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Objective

To assess the effects of lipid-lowering drugs and/or antioxidant vitamins on progression or regression of coronary heart disease as measured by quantitative angiography in patients with low high density lipoprotein (HDL) cholesterol.

Methods

HDL-Atherosclerosis Treatment Study (HATS) was a randomized, 2 x 2 factorial study wherein 160 patients, both men and women with low HDL cholesterol, with at least one 50% stenotic coronary lesion or three 30% stenotic coronary lesions were enrolled. All the patients were randomized into four groups which were simvastatin (10-20g/day) plus niacin (2-4g/day), antioxidant vitamins (vitamins E, C, A and selenium), simvastatin-niacin plus antioxidants; or placebos. The primary end points were arteriographic evidence of a change in coronary stenosis and the occurrence of a first cardiovascular event (death, myocardial infarction, stroke, or revascularization). Coronary angiograms were done at baseline and at three years to assess the change.

Results

  • In the simvastatin-niacin group mean LDL-C was reduced by 42% and mean HDL-C was increased by 26% while levels of LDL-C and HDL-C in the antioxidants and placebo groups remained unaltered.
  • The rate of progression of coronary stenoses was lower in the simvastatin-niacin group compared to the other groups.
  • Patients receiving simvastatin and niacin sustained lower cardiovascular events.
  • Antioxidant vitamins alone had no benefit on progression or on clinical events.

Conclusion

Addition of a drug that increases HDL-C levels to a statin proves to have additional protection over just statin alone.[1]

References

  1. Brown BG, Zhao XQ, Chait A; et al. (2001). "Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease". The New England Journal of Medicine. 345 (22): 1583–92. doi:10.1056/NEJMoa011090. PMID 11757504. Unknown parameter |month= ignored (help)

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