A Randomized Trial of a Strategy for Increasing High-Density Lipoprotein Cholesterol Levels: Effects on Progression of Coronary Heart Disease and Clinical Events

摘要

Background: The high-density lipoprotein (HDL) cholesterol level is a strong predictor of cardiovascular events in epidemiologic studies. Until recently, it has been less extensively studied as a therapeutic target. nnObjective: To assess the angiographic and clinical effects of a pharmacologic strategy to increase HDL cholesterol levels. nnDesign: Randomized, double-blind, placebo-controlled trial conducted from 1993 to 1996. nnSetting: Outpatient specialty clinic of a large U.S. military medical center. nnParticipants: 143 military retirees younger than 76 years of age with low HDL cholesterol levels and angiographically evident coronary disease. nnIntervention: Gemfibrozil, niacin, and cholestyramine or corresponding placebos, with aggressive dietary and lifestyle intervention at baseline. nnMeasurements: Change from baseline to 30 months and a composite measure of clinical events that included hospitalization for angina, myocardial infarction, transient ischemic attack and stroke, death, and cardiovascular procedures.