Trial reportJAMA1995
Effects of lowering elevated LDL cholesterol on the cardiovascular risk of lipoprotein(a).
Trial report in JAMA, 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00000512. Cited by 68 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Familial Atherosclerosis Treatment Study
Open the trial in the graphWho cites it
68 citing papers in PubMed, 4 syntheses or guidelines pooled it, 291 citations in OpenAlex.
- Niacin for primary and secondary prevention of cardiovascular events.The Cochrane database of systematic reviews · 2017 · on this mapPooled it
- Lipoprotein(a) for risk assessment in patients with established coronary artery disease.Journal of the American College of Cardiology · 2014Pooled it
- Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality.JAMA · 2009 · on this mapPooled it
- Efficacy of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors for prevention of stroke.Journal of general internal medicine · 1999Pooled it
- Association Between Lipoprotein(a) and Obstructive Coronary Artery Disease and High-Risk Plaque: Insights From the PROMISE Trial.The American journal of cardiology · 2024Trial
- Lipoprotein(a) concentrations, rosuvastatin therapy, and residual vascular risk: an analysis from the JUPITER Trial (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin).Circulation · 2014 · on this mapTrial
- Relationship of apolipoproteins A-1 and B, and lipoprotein(a) to cardiovascular outcomes: the AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglyceride and Impact on Global Health Outcomes).Journal of the American College of Cardiology · 2013 · on this mapTrial
- Longitudinal cohort study on the effectiveness of lipid apheresis treatment to reduce high lipoprotein(a) levels and prevent major adverse coronary events.Nature clinical practice. Cardiovascular medicine · 2009Trial
- Efficacy and safety of statins in hypercholesterolemia with emphasis on lipoproteins.Heart and vessels · 2005Trial
- Long term statin treatment reduces lipoprotein(a) concentrations in heterozygous familial hypercholesterolaemia.Heart (British Cardiac Society) · 2003Trial
- Lipoprotein(a) levels in Irish subjects from a specialised lipid centre.Irish journal of medical science · 2025Article
- Emerging strategies, applications and challenges of targeting NADNature aging · 2025Review
- Factorial Mendelian randomization of lipoprotein (a) lowering, low-density lipoprotein cholesterol lowering, and lifestyle improvements: joint associations with cardiovascular risk.International journal of epidemiology · 2025Article
- Genetically predicted lipoprotein(a) associates with coronary artery plaque severity independent of low-density lipoprotein cholesterol.European journal of preventive cardiology · 2025Article
- Interaction Between Lipoprotein(a) and Other Lipid Molecules: A Review of the Current Literature.Biomolecules · 2025Review
- Specific circulating miRNAs are associated with plasma lipids in a healthy American cohort.Physiological genomics · 2024Article
- Lipoprotein(a) in Atherosclerotic Diseases: From Pathophysiology to Diagnosis and Treatment.Molecules (Basel, Switzerland) · 2023Review
- Management of Dyslipidemia in Secondary Prevention of Cardiovascular Disease: The Gap between Theory and Practice.Journal of clinical medicine · 2022Article
- Lipoprotein(a) and the Risk for Coronary Heart Disease and Ischemic Stroke Events Among Black and White Adults With Cardiovascular Disease.Journal of the American Heart Association · 2022Article
- The correlation between lipoprotein(a) elevations and the risk of recurrent cardiovascular events in CAD patients with different LDL-C levels.BMC cardiovascular disorders · 2022Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo determine if lowering elevated low-density lipoprotein cholesterol (LDL-C) levels offsets the adverse effect of raised lipoprotein(a) (Lp[a]) levels on coronary artery disease (CAC) in men.
designRandomized, double-blind, placebo-controlled trial of lipid lowering for CAD.
settingPost hoc analysis of the Familial Atherosclerosis Treatment Study.
participantsA total of 146 men aged 62 years or younger with CAD and apolipoprotein B levels of at least 125 mg/dL.
interventionPatients received a Step II Diet and lovastatin (40 mg daily) plus colestipol (30 g daily), niacin (4 g daily) plus colestipol, or placebo (plus colestipol if LDL-C > 90th percentile) for 2.5 years. They were grouped by their LDL-C responses: "minimal" if LDL-C decreased by 10% or less from baseline (mean [SD] change, +6% [13%]) and "substantial" if LDL-C decreased more than 10% (mean [SD] change, -40% [16%]).
main outcome measureImpact of lowering elevated LDL-C on the cardiac event rate (death, myocardial infarction, and revascularization for refractory ischemia) and CAD change associated with elevated Lp(a).
resultsIn multivariate analyses, the best correlate of baseline CAD severity was Lp(a) (r = 0.30; P < .001). For 36 patients with minimal LDL-C reduction, CAD progression correlated only with in-treatment Lp(a) levels (r = 0.45; P < .01), but for 84 patients with substantial LDL-C reduction, disease regressed and its change correlated with in-treatment LDL-C (r = 0.24; P < .05) but not with Lp(a) (r = -0.05). Lipoprotein(a) levels were not significantly altered in either group. For 40 patients with Lp(a) at the 90th percentile or higher, events were frequent (39%) if reduction of LDL-C was minimal, but were few (9%) if reduction was substantial (relative risk, 0.23; 95% confidence interval, 0.06 to 0.99).
conclusionsIn men with CAD and elevated LDL-C, Lp(a) levels were dominant correlates of baseline disease severity, its progression, and event rate over 2.5 years. However, with substantial LDL-C reductions, persistent elevations of Lp(a) were no longer atherogenic or clinically threatening. This provides a possible direction for treatment in such patients with elevated Lp(a) and LDL-C.
Indexed as
Identifiers
7500507W2085713634What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.