Effects of long-term treatment with probucol on serum lipoproteins in cases of familial hypercholesterolemia in the elderly

Effect of antioxidant probucol for preventing stent restenosis

Probucol is a lipid-lowering drug that has an antioxidant effect. The authors sought to investigate the effect of probucol on stent restenosis after the usual 3-day pretreatment protocol. From March 1999 to August 2000, 78 patients (mean age, 56 +/- 8; 49 male) with coronary artery disease who underwent coronary stenting were enrolled. After a diagnostic angiography was done, each eligible patient was randomized to either the probucol or the control group. Following the procedure, ticlopidine was administered for 1 month; aspirin and probucol continuously. Angiographic follow-up was done in 81% (57/70) and angiographic restenosis was not different between the two groups (21% vs. 24%; P = 0.81). In conclusion, antioxidant probucol did not show a beneficial effect on stent restenosis with 3 days of premedication protocol.

Administration of a small amount of lard enhances intimal thickening in the balloon catheter injury model without affecting serum lipids

Effects of fatty acids on intimal thickening induced by a balloon catheter injury model were investigated by feeding rabbits a small amount of either lard [L] or fish oil [F]. Serum lipids of these groups were not different from those of basal diet-fed rabbits [controls] after 4 weeks of feeding. Serum saturated fatty acids such as 14:0, 16:0, and 18.0 were significantly greater in the L-fed rabbits compared with controls, but those of the aorta were not significantly different. Fatty acid composition of the F-fed rabbits was only different from that of the controls in that n-3 fatty acids slightly increased. The mean and maximum intimal thickening 2 weeks after ballooning, carried out 2 weeks after feeding, were significantly higher in the carotid arteries of the L-fed rabbits than in the controls. The intimal thickening of the F-fed rabbits did not significantly differ from that of the controls. These results suggest that lard promotes the formation of the smooth muscle cell dominant type of arteriosclerosis without affecting serum lipid levels.

Diabetic control and progression of retinopathy in elderly patients: five-year follow-up study

OBJECTIVE

To assess whether control of diabetes mellitus is as important in the elderly as in young and middle-aged diabetic patients in terms of progression of retinopathy.

DESIGN

A 5-year longitudinal cohort study.

SETTING

Outpatient diabetic clinic.

PATIENTS

One hundred fourteen non-insulin-dependent diabetic patients (30 males, 84 females) > or = 60 years of age.

MEASUREMENTS

Retinopathy was checked at the beginning and end of the follow-up period. During the 5-year follow-up period, demographic variables, body mass index, HbA1c, blood pressure, and plasma lipids were monitored. Retinopathy was classified as follows: grade 0, no lesion; grade 1, non-proliferative retinopathy; grade 2, pre-proliferative retinopathy; grade 3, proliferative retinopathy. Progression of retinopathy during the 5-year follow-up was defined as an increase in its grade.

RESULTS

At the start of the study, 13% of the patients already had retinopathy, all of grade 1. The 5-year follow-up study showed that progression of retinopathy was 23.6% in all cases, 22.2% in those with grade 0 initially, and 33.3% in those with grade 1 initially. The progression rates of retinopathy as a function of the mean HbA1c during the follow-up were as follows: lower than 7%, 2%; 7-8%, 20%; 8-9%, 40%; more than 9%, 61%. Multiple logistic regression analysis showed that, of the parameters examined, only HbA1c was a significant risk factor for progression of retinopathy.

CONCLUSIONS

Control of diabetes mellitus is the most important factor associated with prevention of progression of retinopathy in elderly patients.