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In a previous randomized placebo-controlled trial, investigators
demonstrated that 2-year pravastatin treatment
induced a significant regression of carotid
intima-media thickness (IMT) in 8- to
18-year-old children with familial
hypercholesterolemia. The investigators
continued to follow up these children to explore
the relation between the age of statin
initiation and carotid IMT after follow-up on
statin treatment. They also examined safety
aspects of statin therapy during this long-term
follow-up.
All 214 children who initially participated in the
previous placebo-controlled study were eligible
for the follow-up study. After completion of the
placebo-controlled study, all children continued
treatment with pravastatin 20 or 40 mg,
depending on their age. Blood samples were taken
on a regular basis for lipids and safety
parameters, and a carotid IMT measurement was
performed after an average treatment period of
4.5 years. Follow-up data for 186 children were
available for the statistical analyses.
Multivariate analyses revealed that age at
statin initiation was an independent predictor
for carotid IMT after follow-up with adjustment
for carotid IMT at initiation of statin
treatment, sex, and duration of treatment. Early
initiation of statin treatment was associated
with a subsequently smaller IMT. Furthermore, no
serious laboratory adverse events were reported
during follow-up, and statin treatment had no
untoward effects on sexual maturation.
These data indicate that early initiation of statin
treatment delays the progression of carotid IMT
in adolescents and young adults. The present
study shows for the first time that early
initiation of statin therapy in children with
familial hypercholesterolemia might be
beneficial in the prevention of atherosclerosis
in adolescence.
Circulation; 2007 Aug 7;116(6):664-8
Circulation; 2007 Aug 7;116(6):664-8
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