Related Experiment Video
Updated: Jan 9, 2026
01:27
Pulmonary Embolism III: Nursing Management
Published on: June 19, 2025
320
Effect of ACAT inhibition on the progression of coronary atherosclerosis
Steven E Nissen1, E Murat Tuzcu, H Bryan Brewer
1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. nissens@ccf.org
The New England Journal of Medicine
|March 24, 2006
Summary
Acyl-coenzyme A:cholesterol acyltransferase (ACAT) inhibitors did not reduce atherosclerosis progression in patients with coronary disease. Treatment with pactimibe did not improve the primary outcome and worsened secondary measures of atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biochemistry
Background:
- Acyl-coenzyme A:cholesterol acyltransferase (ACAT) esterifies cholesterol.
- ACAT inhibitors have shown antiatherosclerotic effects in animal models.
Purpose of the Study:
- To evaluate the efficacy of the ACAT inhibitor pactimibe in patients with coronary disease.
- To assess the impact of pactimibe on atherosclerosis progression using intravascular ultrasonography.
Main Methods:
- 408 patients with coronary disease received usual care plus either pactimibe (100 mg/day) or placebo.
- Intravascular ultrasonography was performed at baseline and after 18 months.
- Primary efficacy variable was change in percent atheroma volume.
Main Results:
- Pactimibe did not significantly differ from placebo in the primary efficacy variable (change in percent atheroma volume).
- Pactimibe treatment showed unfavorable effects on secondary efficacy measures, including less regression of normalized total atheroma volume and atheroma volume in the most diseased segment compared to placebo.
- No significant difference in the combined incidence of adverse cardiovascular outcomes between groups.
Conclusions:
- ACAT inhibition with pactimibe is not effective for limiting atherosclerosis progression in patients with coronary disease.
- ACAT inhibition may adversely affect atherosclerosis measures and potentially promote atherogenesis.
- The study suggests ACAT inhibition is not a viable therapeutic strategy for atherosclerosis.
Related Concept Videos
01:27Pulmonary Embolism III: Nursing Management
320
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
320
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
277
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
277
01:29Pulmonary Embolism I: Introduction
464
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
464
01:29Venous Thrombosis III: Interprofessional Care
262
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
262
01:27Pneumothorax-II
852
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
852
01:29Chronic Obstructive Pulmonary Disease-V: Management
3.1K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
3.1K