Angiographic trials of lipid-lowering therapy: an update

The value of specific LDL apheresis in drug-resistant cases of hyperlipidaemia is reviewed, as well as new data on the prevention of new lesion formation, efficacy of therapy based on initial lipid levels, and the consequences of lipid lowering in the angioplasty setting. Studies undertaken in the carotid and femoral bed are included, as is a brief discussion of the use of probucol as an adjunct to lipid-lowering therapy. These studies have emerged on a backdrop of data focused more on reduction of clinical events than on morphologic changes. Studies on the clinical impact of lipid-lowering therapy are included to provide a linkage between the rationale and conclusions of the angiographic trials with the emerging demonstration that cholesterol lowering does indeed reduce both cardiovascular and total mortality without inducing significant noncardiovascular morbidity or mortality.