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Cited by 843Lipoproteins and Cardiovascular HealthCholesterol and Lipid MetabolismCoronary Interventions and Diagnostics

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Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas' Atherosclerosis Regression Study (STARS)

Watts, G.F, Lewis, B, Lewis, E.S, Coltart, D.J, Smith, L.D.R, Swan, A.V, Brunt, J.N.H, Mann, J.I·1992·The Lancet
DOI 10.1016/0140-6736(92)90863-x
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Abstract

To assess the effect of dietary reduction of plasma cholesterol concentrations on coronary atherosclerosis, we set up a randomised, controlled, end-point-blinded trial based on quantitative image analysis of coronary angiograms in patients with angina or past myocardial infarction. Another intervention group received diet and cholestyramine, to determine the effect of a greater reduction in circulating cholesterol concentrations. 90 men with coronary heart disease (CHD), who had a mean (SD) plasma cholesterol of 7.23 (0.77) mmol/l were randomised to receive usual care (U, controls), dietary intervention (D), or diet plus cholestyramine (DC), with angiography at baseline and at 39 (SD 3.5) months. Mean plasma cholesterol during the trial period was 6.93 (U), 6.17 (D), and 5.56 (DC) mmol/l. The proportion of patients who showed overall progression of coronary narrowing was significantly reduced by both interventions (U 46%, D 15%, DC 12%), whereas the proportion who showed an increase in luminal diameter rose significantly (U 4%, D 38%, DC 33%). The mean absolute width of the coronary segments (MAWS) studied decreased by 0.201 mm in controls, increased by 0.003 mm in group D, and increased by 0.103 mm in group DC (p less than 0.05), with improvement also seen in the minimum width of segments, percentage diameter stenosis, and edge-irregularity index in intervention groups. The change in MAWS was independently and significantly correlated with LDL cholesterol concentration and L…

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Metadata

Authors
Watts, G. F., Lewis, B., Lewis, E. S., Coltart, D. J., Smith, L. D. R., Swan, A. V., Brunt, J. N. H., & Mann, J. I.
Affiliations
  • St Thomas' Hospital (GB)
  • University of Manchester (GB)
  • University of Otago (NZ)
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
1992-03
Volume
339
Issue
8793
Pages
563-569
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/0140-6736(92)90863-x
OpenAlex
W2132942256
Cited by
843
References
34
Citations by year
2026: 2 · 2025: 4 · 2024: 9 · 2023: 8 · 2022: 4 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 9 · 2017: 7 · 2016: 9 · 2015: 10 · 2014: 10 · 2013: 15 · 2012: 11
FWCI
103.88
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
Keywords
coronary artery disease, lipid-lowering diet, cholestyramine, dietary cholesterol reduction, coronary atherosclerosis regression, coronary angiography, coronary lumen diameter, LDL cholesterol, LDL/HDL ratio, cardiovascular events, hypercholesterolemia
MeSH terms
Angina Pectoris, Cholesterol, Cholestyramine Resin, Combined Modality Therapy, Coronary Artery Disease, Coronary Disease, Humans, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Remission Induction, Treatment Outcome, Coronary Angiography

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