ÿþ<HTML> <HEAD> <TITLE> =B5=A82=>5 A=865=85 ;8?84>2 8 ?@>3@5AA8@>20=85 0B5@>A:;5@>70: 8AA;54>20=85 REVERSAL</TITLE> <META NAME="keywords" CONTENT="0B5@>A:;5@>7, 38?5@;8?845<8O, AB0B8=K, 0B>@20AB0B8=, ?@020AB0B8=, :0@48>;>38O"> <link rel=stylesheet href="athero.css" type="text/css"> </head> <BODY BGCOLOR="#ffffff" link=#993366 vlink=#993366 alink=#993366 topmargin=0 leftmargin=0> <table cellspacing=0 cellpadding=0 border=0 width=760> <tr><td width=230 valign=top><iframe width=220 height=1800 frameborder=0 vspace=0 hspace=0 marginwidth=0 marginheight=0 scrolling=no src="nav_root.htm"></iframe> </td><td valign=top><img src="http://counter.rambler.ru/top100.cnt?352447" alt="" width=1 height=1 border=0 align=right> <h2><a href=index.htm>>2>AB8 :0@48>;>388</a></h2> <h3> =B5=A82=>5 A=865=85 C@>2=O 0B5@>35==KE ;8?84>2 >AB0=02;8205B ?@>3@5AA8@>20=85 :>@>=0@=>3> 0B5@>A:;5@>70 ?> 40==K< 2=CB@8:>@>=0@=>3> C;LB@072C:>2>3> 8AA;54>20=8O: @57C;LB0BK 8A?KB0=8O REVERSAL </h3> <p><b>Intensive Lipid Lowering Stops Progression of Coronary Atherosclerosis as Assessed by Intracoronary Ultrasound: Results of REVERSAL Trial</b></p> <dd> >43>B>2;5=> ..>:@>2A:>9 </dd> <p align=justify>AA;54>20=8O A ?@8<5=5=85< @5=B35=>:>=B@0AB=>9 0=38>3@0D88 ?>:070;8, GB> AB0B8=K B>;L:> 70<54;ONB ?@>3@5AA8@>20=8O :>@>=0@=>3> 0B5@>A:;5@>70 [1-5]. 4=0:> 8A?>;L7>202H85AO 2 MB8E 8AA;54>20=8OE ;>20AB0B8=, ?@020AB0B8= 8 D;C20AB0B8= =5 ?>72>;O;8 4>18BLAO A=865=8O E>;5AB5@8=0 ;8?>?@>B58=>2 =87:>9 ?;>B=>AB8 (%!), :>B>@>5 2>7<>6=> A ?><>ILN ?>O282H53>AO ?>765 0B>@20AB0B8=0. !?>A>1=>ABL 0B>@20AB0B8=0 2;8OBL =0 48=0<8:C 0B5@>A:;5@>B8G5A:8E 87<5=5=89 2 :>@>=0@=KE 0@B5@8OE 87CG0;0AL 2 =5402=> 7025@H82H5<AO 8A?KB0=88 REVERSAL . ;O >F5=:8 87<5=5=89 2K@065==>AB8 0B5@>A:;5@>B8G5A:8E 87<5=5=89 2 =5< 2?5@2K5 8A?>;L7>20;>AL 2=CB@8A>AC48AB>5 C;LB@072C:>2>5 8AA;54>20=85.  >B;8G85 >B @5=B35=>:>=B@0AB=>9 0=38>3@0D88, 40NI59 ?@54AB02;5=85 B>;L:> > A>AB>O=88 ?@>A25B0 0@B5@88, MB>B <5B>4 ?>72>;O5B >F5=8BL >1J5< 0B5@>A:;5@>B8G5A:>9 1;OH:8, 2:;NG0O 55 G0ABL, @0A?>;>65==CN 2=CB@8 0@B5@80;L=>9 AB5=:8. <p align=justify>59AB285 0B>@20AB0B8=0 (8A?>;L7>20;0AL 53> <0:A8<0;L=0O 4>70 80 <3/ACB) 2 REVERSAL A@02=820;>AL A 459AB285< ?@020AB0B8=0 2 AB0=40@B=>9 4;O MB>3> AB0B8=0 4>75 40 <3/ACB, :0: 38?>;8?845<8G5A:>3> 2<5H0B5;LAB20 C<5@5==>9 8=B5=A82=>AB8. 725AB=>, GB> ?@020AB0B8= 2 MB>9 4>75 70<54;O; ?@>3@5AA8@>20=85 :>@>=0@=>3> 0B5@>A:;5@>70 [2,3] 8 A=860; G0AB>BC 2>7=8:=>25=8O >A=>2=KE :>@>=0@=KE A>1KB89. <p><b>0B5@80; 8 <5B>4K</b></p> <p align=justify>A?KB0=85 REVERSAL 1K;> 42>9=K< A;5?K<, @0=4><878@>20==K<, <=>3>F5=B@>2K<.  =53> 2:;NG5=> 654 1>;L=KE A :;8=8G5A:8<8 ?@>O2;5=8O<8 ! 8 AB5=>7>< :>@>=0@=>9 0@B5@88, ?@52KH02H8< 20% 55 ?@>A25B0, :>B>@KE @0=4><878@>20;8 : ?@85<C ?@020AB0B8=0 (40 <3/ACB) 8;8 0B>@20AB0B8=0 2 (80 <3/ACB). 0:>=G8;8 8AA;54>20=85, ?@>4>;602H55AO 18 <5AOF52, 502 G5;>25:0 (249 2 3@C??5 ?@020AB0B8=0 8 253  0B>@20AB0B8=0). #@>25=L %!  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A=878;AO A> A@54=53> 4;O 42CE 3@C?? 150.2 <3/4; 4> 110 <3/4; ( 25.2%) 2 3@C??5 ?@020AB0B8=0 8 4> 79 <3/4; ( 46.3%) 2 3@C??5 0B>@20AB0B8=0 (p<0.0001). &5;52>3> 7=0G5=8O (=865 100 <3/4; 8;8 2.6 <<>;L/;) 4>AB83;8 67% 1>;L=KE 3@C??K ?@020AB0B8=0 8 97% 3@C??K 0B>@20AB0B8=0. #@>25=L " A=878;AO A> A@54=53> 4;O 42CE 3@C?? 197 <3/4; 4> 166 <3/4; (-6.8%) 2 3@C??5 ?@020AB0B8=0 8 4> 148 <3/4; (-20%) 2 3@C??5 0B>@20AB0B8=0 (p=0.0009). #@>25=L %!  ?>2KA8;AO A>>B25BAB25==> =0 5.6% 8 2.9% (p=0.06). !CI5AB25==>5 @07;8G85 <564C 3@C??0<8 >B<5G5=> 2 AB5?5=8 A=865=8O C@>2=O !-@50:B82=>3> 15;:0 (! ) - =0 5.2% 2 3@C??5 ?@020AB0B8=0 8 =0 36.4% 2 3@C??5 0B>@20AB0B8=0 (p<0.0001). <p align=justify># 1>;L=KE, ?>;CG02H8E ?@020AB0B8=, >1J5< 0B5@><K C25;8G8;AO =0 2.7% (p=0.001) 2 A@02=5=88 A 8AE>4=K<, B>340 :0: 2 3@C??5 0B>@20AB0B8=0 4>AB>25@=KE 87<5=5=89 MB>3> ?>:070B5;O =5 ?@>87>H;> (-0.4%, @=0.98). !:>@>ABL ?@>3@5AA8@>20=8O 0B5@>A:;5@>70, >F5=5==0O ?> 87<5=5=8N >1J5<0 0B5@><K 2 ?@>F5=B0E >B 8AE>4=>3>, 1K;0 4>AB>25@=> <5=LH5 2 3@C??5 0B>@20AB0B8=0 (@=0.02). 07;8G85 <564C 42C<O 3@C??0<8 ?> 87<5=5=8N >1AB@C:F8>==>3> (>1BC@8@CNI53>) >1J5<0 0B5@><K 1K;> B0:65 4>AB>25@=K< (p=0.0002).  3@C??5 ?@020AB0B8=0 >1AB@C:F8>==K9 >1J5< 0B5@><K C25;8G8;AO =0 1.6%, 2 3@C??5 0B>@20AB0B8=0  =0 0.18%. 065 C B5E 67% 1>;L=KE 3@C??K ?@020AB0B8=0, C :>B>@KE 1K; 4>AB83=CB F5;52>9 C@>25=L %!  <100 <3/4; (A@54=89 %!  C MB8E 1>;L=KE 88 <3/4;), >B<5G5=> 4>AB>25@=>5 C25;8G5=85 @07<5@0 1;OH5: 2 :>@>=0@=KE 0@B5@8OE. C ! 4@C3>9 AB>@>=K, C <=>38E 1>;L=KE, ?>;CG02H8E 0B>@20AB0B8=, ?@8 8=48284C0;L=>9 >F5=:5 >B<5G5=> C<5=LH5=85 @07<5@0 0B5@>A:;5@>B8G5A:>3> ?>@065=8O. <p align=justify>>AB>25@=KE @07;8G89 <564C 3@C??0<8 ?> G0AB>B5 A;CG052 A<5@B8, 8=D0@:B>2 8 8=AC;LB>2, 0 B0:65 A;CG052 ?>2KH5=8O B@0=A0<8=07 8;8 $ :@>28 =5 1K;>. !;CG052 <8>?0B89 >B<5G5=> =5 1K;>. <p><b>0:;NG5=85</b></p> <p align=justify>"0:8< >1@07><, 2 8A?KB0=88 REVERSAL ?@8<5=5=85 2 B5G5=85 18 <5AOF52 0B>@20AB0B8=0 2 <0:A8<0;L=>9 4>75 (B.5. «8=B5=A82=>5 38?>;8?845<8G5A:>5 ;5G5=85» A 2K@065==K< A=865=85< C@>2=O %!) >AB0=>28;> ?@>3@5AA8@>20=85 0B5@>A:;5@>B8G5A:8E 87<5=5=89 :>@>=0@=>9 0@B5@88. 8?>;8?845<8G5A:>5 ;5G5=85 C<5@5==>9 8=B5=A82=>AB8 (?@8<5=5=85 ?@020AB0B8=0) B0:8< MDD5:B>< =5 A>?@>2>640;>AL. KO2;5==K5 @07;8G8O 2 48=0<8:5 0B5@>A:;5@>70 02B>@K A2O7K20NB A 1>;55 2K@065==K< 2;8O=85< 0B>@20AB0B8=0 =0 C@>2=8 :0: 0B5@>35==KE ;8?>?@>B58=>2, B0: 8 ! . </p> <p><b>8B5@0BC@0</b></p> <ol> <li>Waters D., Higginson L., Gladstone P., et al. The CCAIT Study Group: Effects of monotherapy with an HMG-CoA reductase inhibitor on the progression of coronary atherosclerosis as assessed by serial quantitative arteriography: The Canadian Coronary Atherosclerosis Interventional Trial. Circulation 1994; 89:959-968, <li>Jukema J. W., Brushke A. V. G., van Boven A. J., et al. On behalf of the REGRESS Study Group: Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels: The Regression Growth Evaluation Statin Study (REGRESS). Circulation 91:2528-2540. <li>Pitt B., Mancini G. B. J., Ellis S. G., et al. For the PLAC I Investigators. Pravastatin Limitation of Atherosclerosis in the Coronary Arteries (PLAC I): Reduction in atherosclerosis progression and clinical events. J Am Coll Cardiol 1995; 26:1133-1139,. <li>Herd J. A., Ballantyne C. M., Farmer J. A., et al. The LCAS Investigators: Effects of fluvastatin on coronary atherosclerosis in patients with mild to moderate cholesterol elevations (Lipoprotein and Coronary Atherosclerosis Study [LCAS]). Am J Cardiol 1997; 80:278-286, <li>Post Coronary Artery Bypass Graft Trial Investigators: The effect of aggressive lowering of low density lipoprotein cholesterol levels and low dose anticoagulation on obstructive changes in saphenous-vein coronary artery bypass grafts. N Engl J Med 1997; 336:153-162, <li>Nissen S.E., for the REVERSAL Investigators. Comparison of Intensive Versus Moderate Lipid Lowering on the Progression of Coronary Atherosclerosis Measured by Intravascular Ultrasound: A Randomized Controlled Trial (abstract). Circulation 2003; 108:2723 (Late-Breaking Clinical Trials Abstracts). <li>Nissen S.. Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL): A Prospective, Randomized, Double-blind, Multi-center Study Comparing the Effects of Atorvastatin Versus Pravastatin on the Progression of Coronary Atherosclerotic Lesions as Measured by Intravascular Ultrasound. <a href= www.sessionsonline.org> www.sessionsonline.org</a>. </li> </ol> <p><i>?C1;8:>20=> 2 6C@=0;5 "0@48>;>38O" 2004, !4, AB@.93</i> </td></tr> </table> </HTML>