Is Intravascular Ultrasound the Gold Standard Surrogate for Clinically Relevant Atherosclerosis Progression?
B. Greg Brown, MD, PhD* and
Xue-Qiao Zhao, MD
Cardiology Division, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
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Figure 1 Mean Stenosis Change by QCA: Effects of Therapy and In-Trial Events
Impact of intensive therapy and of an in-trial cardiovascular event on the average in-trial change in coronary stenosis (%S) in all coronary stenoses (n = 4,450) measured in 393 patients participating in 3 pooled trials (16,17,38) that compared intensive combination therapy (niacin + colesipol, lovastatin + colestipol, simvastatin + niacin, or niacin + gemfibrozil + cholestyramine) against placebo. In treated and in placebo patients, the measured mean stenosis progression was significantly greater among patients with events than among those without events (p = 0.005 and p = 0.0001, respectively). Forty-four of 182 placebo-treated and 18 of 213 intensively treated patients had events, a 65% risk reduction with treatment versus placebo (p = 0.0001). Pt = patient; QCA = quantitative coronary arteriography; Rx = treatment.
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