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INTERNATIONAL ANGIOLOGY

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Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1999 Dicembre;18(4):313-9

lingua: Inglese

The ­effect of four-year hypo­lip­i­daem­ic treat­ment on the inti­mal thick­ness of the com­mon carot­id ­artery in ­patients with famil­iar hyper­lip­i­dae­mia

Spacil J., Ceska R., Petrasek J., Sobra J. †

From the Department of Internal Medicine III, General Teaching Hospital and Charles University School of Medicine I, Prague, Czech Republic


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Background. Cholesterol low­er­ing in ­patients with above-aver­age cho­les­te­rol lev­els has been shown to ­reduce the pro­gres­sion of ath­ero­scler­o­sis. We ­assess the ­effects of lipid low­er­ing ther­a­py on the pro­gres­sion of early, pre­in­tru­sive carot­id arte­ri­al ath­ero­scler­o­sis in high risk ­patients with famil­ial hyper­lip­i­dae­mia free of symp­to­mat­ic car­di­o­vas­cu­lar dis­ease.
Methods. Fifty-two ­patients with famil­ial hyper­lip­i­dae­mia by were treat­ed by diet and var­i­ous hypo­lip­i­daem­ic drugs. Eighteen indi­vid­u­als were not tak­ing hypo­lip­i­daem­ic drugs. In a pros­pec­tive study by B-mode ultra­sound we ­assessed the inti­ma-media thick­ness of the dis­tal com­mon carot­id arte­ri­al (CCA) far wall at base­line and after 4 years.
Results. In a sub­group of 25 ­patients with famil­ial hyper­cho­les­ter­o­lae­mia there was a sig­nif­i­cant ­decrease in total and LDL cho­les­te­rol and reduc­tion in the inti­ma-media thick­ness (IMT) of the com­mon carot­id ­artery from 0.78±0.22 mm to 0.69±0.17 mm (p=0.004). In a sub­group of 27 ­patients with famil­ial com­bined hyper­lip­i­dae­mia sig­nif­i­cant ­decreases in total and LDL cho­les­te­rol and tri­gly­ce­rides were asso­ciat­ed with a ­decrease in the IMT of com­mon carot­id. ­artery from 0.72±0.22 mm to 0.67±0.15 mm (p=0.044). In 18 indi­vid­u­als, who were not tak­ing hypo­lip­i­daem­ic drugs, there were no sig­nif­i­cant chang­es in the lev­els of cho­les­te­rol and tri­gly­ce­rides and in the IMT of the com­mon carot­id ­artery (­increase from 0.58±0.18 mm to 0 62±0.13 mm, p>0.05).
Conclusions. Lipid-low­er­ing ther­a­py in ­patients with famil­ial hyper­lip­i­dae­mia free of symp­to­mat­ic car­di­o­vas­cu­lar dis­ease ­reverses the pro­gres­sion of early, pre­in­tru­sive ath­ero­scler­o­sis of the carot­id ­artery. It is a ben­e­fi­cial sign indi­cat­ing the pos­sibil­ity for ath­ero­scler­o­sis regres­sion.

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