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Drug Reverses Artery Disease, Study Finds

November 20, 1991|JANNY SCOTT | TIMES MEDICAL WRITER

A popular cholesterol-lowering drug used by as many as 1 million Americans cannot only slow the progress of coronary artery disease but also reverse it, according to findings by USC researchers that could help reduce the death toll of the country's No. 1 killer.

The findings emerged recently in an unpublished study of the effectiveness of the drug lovastatin in fending off the fatty deposits that can clog coronary arteries. The researchers compared patients receiving the drug to similar patients who took placeboes.

The difference was apparently so dramatic that researchers recently ended the study two years early and started giving the drug to the control group as well.

The lead researcher, however, declined to discuss the findings in detail.

The study is not the first to show that it is possible to reverse the course of coronary artery disease, which was once thought to be inevitably progressive. But lovastatin is the first single drug shown to be effective; other studies have documented improvement in patients taking multiple medications, undergoing surgery or making major lifestyle changes.

It is widely accepted that high levels of cholesterol in the blood can cause the arteries to narrow from fat, cholesterol and other substances forming lesions on the artery walls. A severe reduction in the flow of blood can cause a heart attack, in which heart muscle dies, or angina, a chest pain caused by insufficient blood flow to the heart.

The USC study, headed by Dr. David Blankenhorn, professor of medicine at the USC School of Medicine and director of the Atherosclerosis Research Institute, tracked the progression or regression of coronary artery disease in 270 men and women over a two-year period.

The course of their disease was tracked using angiography, a kind of X-ray inspection of the inside of the heart and blood vessels. Though there was an option to continue the study for another two years, the researchers terminated it this year, Blankenhorn said Tuesday night.

The first suggestion that coronary artery disease might be reversed, and the fatty lesions could be shrunk, emerged from another study by Blankenhorn in 1987. Since then, about half a dozen studies using angiography have shown that drugs, surgery and lifestyle changes can reduce the size of fatty deposits in the arteries.

For example, it has been shown that men who receive lovastatin, colestipol and niacin can experience decreases in artery-clogging plaques. Other studies have found similar effects in patients put on low-fat diets and exercise, and in patients receiving a form of intestinal bypass surgery.

But by comparison, lovastatin, also known as Mevacor, is relatively easy to take and is known to have few side effects, Blankenhorn said.

Blankenhorn intends to continue to follow the patients in the lovastatin study to see whether the changes that have occurred so far continue.

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