PRAVASTATIN, LIPIDS, AND ATHEROSCLEROSIS IN THE CAROTID ARTERIES (PLAC-II)

We randomized 151 coronary-patients to placebo or pravastatin and trea ted them for 3 years. B-mode ultra-sound quantification of carotid art ery intimal-medial thickness (IMT) was obtained at baseline and sequen tially during this period. The primary outcome was the change in the m ean of the maximal IMT measurements across time. Effects on individual carotid artery segments (common, bifurcation, and internal carotid) a nd on clinical events were also investigated. Plasma concentrations of total cholesterol were lower with active treatment than with placebo (4.80 vs 6.07 mmol/L [186 vs 235 mg/dl], respectively) as were concent rations of low-density lipoprotein cholesterol (3.11 vs 4.30 mmol/L [1 20 vs 167 mg/dl], respectively). Plasma concentrations of high-density lipoprotein(2) cholesterol were higher with active treatment (0.16 vs 0.14 mmol/L [6.1 vs 5.5 mg/dl], respectively). Active treatment resul ted in a nonsignificant 12% reduction in progression of the mean-maxim um IMT (from 0.068 to 0.059 mm/year) and a statistically significant 3 5% reduction in IMT progression in the common carotid. Active treatmen t was also associated with a reduction in fatal and nonfatal myocardia l infarction (p = 0.09) and of any fatal event plus nonfatal myocardia l infarction (p = 0.04).