EFFECT OF PRAVASTATIN (10 MG DAY) ON PROGRESSION OF CORONARY ATHEROSCLEROSIS IN PATIENTS WITH SERUM TOTAL CHOLESTEROL LEVELS FROM 160 TO 220 MG/DL AND ANGIOGRAPHICALLY DOCUMENTED CORONARY-ARTERY DISEASE/

To evaluate the effect of pravastatin on progression of coronary ather osclerosis in normocholesterolemic patients with coronary artery disea se (CAD), 90 patients with CAD and serum cholesterol levels of 160 to 220 mg/dl were randomized into a pravastatin (10 mg/day) group (n = 45 ) and control group (n = 45) in a 2-year study. The proportions of pat ients with progression (an increase of greater than or equal to 15% in percent stenosis) and regression (a decrease of greater than or equal to 15% in percent stenosis) of coronary atherosclerosis were compared between the 2 groups. Of 90 patients, 80 (89%) had a final angiogram: the pravastatin (n = 39) and control group (n = 41). Percent changes in total cholesterol, low-density lipoprotein cholesterol, and apoprot ein B levels were significantly greater in the pravastatin group than in the control group (total cholesterol -11 +/- 12% vs 3 +/- 15%, p <0 .01; low-density lipoprotein cholesterol -18 +/- 16% vs 4 +/- 21%, p < 0.01; apoprotein B -5 +/- 20% vs 6 +/- 20%, p <0.05). The proportion o f patients with progression of coronary atherosclerosis was significan tly smaller in the pravastatin group than in the control group (21% vs 49%, p <0.05). The proportion of patients with disease regression did not differ in the 2 groups (3% vs 2%, p = NS). In conclusion, this st udy indicates that cholesterol-lowering therapy with pravastatin can p revent the progression of coronary atherosclerosis even in normocholes terolemic patients with established CAD. (C) 1997 by Excerpta Medica, Inc.