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Lovastatin Reduces Coronary Events Based on Cholesterol

Substantial changes in HDL and LDL cholesterol in the first year linked to greatest risk reductions

MONDAY, Sept. 14 (HealthDay News) -- Patients with no cardiovascular risk factors who take lovastatin have a lower risk of developing major coronary events if they have substantial increases in high-density lipoprotein (HDL) cholesterol and substantial decreases in low-density lipoprotein (LDL) cholesterol in the first year of treatment, according to a study in the Sept. 15 issue of the American Journal of Cardiology.

Yadong Cui, M.D., from Merck & Company in Whitehouse Station, N.J., and colleagues analyzed data from 2,928 patients with no history of atherosclerotic cardiovascular disease, average levels of LDL cholesterol, and low levels of HDL cholesterol who had been treated with lovastatin.

The researchers found that after one year of treatment, LDL cholesterol was reduced by 25 percent and HDL cholesterol increased by 6 percent. During a follow-up of 5.2 years, patients whose HDL cholesterol increased by 7.5 percent or more after one year had a lower rate of acute major coronary events than those with a smaller HDL cholesterol increase (5.18 compared with 7.66 per 1,000 person-years). Patients who had both an increase in HDL cholesterol of 7.5 percent or more and LDL cholesterol of less than 115 mg/dL had the lowest event rate (3.53 per 1,000 person-years).

"In conclusion, lovastatin therapy was associated with a greater risk reduction of acute major coronary events when LDL cholesterol was substantially reduced and the HDL cholesterol increased by 7.5 percent or more," Cui and colleagues write.

The study was supported by Merck & Company Inc. Several study authors are employees and shareholders of Merck and other pharmaceutical companies.

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