Program on the surgical control of the hyperlipidemias: 1994 report

for the POSCH Group

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The Program on the Surgical Control of the Hyperlipidemias (POSCH), a randomized clinical trial, tested the hypothesis that cholesterol modification induced by partial ileal bypass would favorably affect mortality and morbidity due to coronary heart disease (CHD). The study population consisted of 838 patients (417 in the control group and 421 in the surgery group) in four clinical centers, both men (90.7%) and women with an average age of 51 years who had survived a first myocardial infarction. The lipid changes in POSCH have been the most marked in any atherosclerosis intervention trial utilizing a single mode of intervention in addition to diet therapy. At 5 years, the surgery group, compared with the control group, had a 23.3 ± 1.0% (mean ± SE) lower total plasma cholesterol level (p < 0.0001), a 37.7 < 1.2% lower low-density lipoprotein cholesterol level (p < 0.0001), and a 4.3 ± 1.8% higher high-density lipoprotein cholesterol level (p = 0.02). For the combined end point of CHD mortality and confirmed nonfatal myocardial infarction, there was a 35.0% reduction in the surgery group (p < 0.001). Coronary artery bypass grafting was reduced in the surgery group by 62.0% (p < 0.0001) and percutaneous transluminal coronary angioplasty was reduced by 55.0% (p < 0.01). A comparison of baseline coronary arteriograms with those obtained at 3, 5, 7, and 10 years consistently showed less atherosclerosis disease progression (p < 0.001) and greater atherosclerosis disease regression at 5 and 7 years (p < 0.01) in the surgery group. At formal trial completion in July 1990, the overall mortality in the surgery subgroup with an ejection fraction of 50% or greater was 36.1% lower (p = 0.02). During subsequent follow-up, trends toward statistical significance for differences in both CHD and in overall mortality have become evident. The POSCH results provide strong support for beneficial clinical and arteriographie reduction of atherosclerosis progression after lipid modification by partial ileal bypass.

Original languageEnglish (US)
Pages (from-to)S3-S10
JournalJournal of Cardiovascular Pharmacology
Volume25
StatePublished - 1995
Externally publishedYes

Fingerprint

Hyperlipidemias
Atherosclerosis
Coronary Disease
Mortality
Myocardial Infarction
Cholesterol
Diet Therapy
Lipids
Control Groups
Coronary Balloon Angioplasty
Coronary Artery Bypass
LDL Cholesterol
HDL Cholesterol
Disease Progression
Randomized Controlled Trials
Morbidity
Population

Keywords

  • Atherosclerosis
  • Cholesterol
  • Coronary heart disease
  • Partial ileal bypass
  • POSCH
  • Randomized trial

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology

Cite this

Program on the surgical control of the hyperlipidemias : 1994 report. / for the POSCH Group.

In: Journal of Cardiovascular Pharmacology, Vol. 25, 1995, p. S3-S10.

Research output: Contribution to journalArticle

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title = "Program on the surgical control of the hyperlipidemias: 1994 report",
abstract = "The Program on the Surgical Control of the Hyperlipidemias (POSCH), a randomized clinical trial, tested the hypothesis that cholesterol modification induced by partial ileal bypass would favorably affect mortality and morbidity due to coronary heart disease (CHD). The study population consisted of 838 patients (417 in the control group and 421 in the surgery group) in four clinical centers, both men (90.7{\%}) and women with an average age of 51 years who had survived a first myocardial infarction. The lipid changes in POSCH have been the most marked in any atherosclerosis intervention trial utilizing a single mode of intervention in addition to diet therapy. At 5 years, the surgery group, compared with the control group, had a 23.3 ± 1.0{\%} (mean ± SE) lower total plasma cholesterol level (p < 0.0001), a 37.7 < 1.2{\%} lower low-density lipoprotein cholesterol level (p < 0.0001), and a 4.3 ± 1.8{\%} higher high-density lipoprotein cholesterol level (p = 0.02). For the combined end point of CHD mortality and confirmed nonfatal myocardial infarction, there was a 35.0{\%} reduction in the surgery group (p < 0.001). Coronary artery bypass grafting was reduced in the surgery group by 62.0{\%} (p < 0.0001) and percutaneous transluminal coronary angioplasty was reduced by 55.0{\%} (p < 0.01). A comparison of baseline coronary arteriograms with those obtained at 3, 5, 7, and 10 years consistently showed less atherosclerosis disease progression (p < 0.001) and greater atherosclerosis disease regression at 5 and 7 years (p < 0.01) in the surgery group. At formal trial completion in July 1990, the overall mortality in the surgery subgroup with an ejection fraction of 50{\%} or greater was 36.1{\%} lower (p = 0.02). During subsequent follow-up, trends toward statistical significance for differences in both CHD and in overall mortality have become evident. The POSCH results provide strong support for beneficial clinical and arteriographie reduction of atherosclerosis progression after lipid modification by partial ileal bypass.",
keywords = "Atherosclerosis, Cholesterol, Coronary heart disease, Partial ileal bypass, POSCH, Randomized trial",
author = "{for the POSCH Group} and Henry Buchwald and Campos, {Christian T.} and Leon, {Arthur S.} and Jean Rindal and Hagen, {Rebecka A.} and Campbell, {Gilbert S.} and Pearce, {Malcolm B.} and Bissett, {Joseph K.} and Stuenkel, {Meredith R.} and Yellin, {Albert E.} and {Edmiston Allan}, W. and Fujii, {Dorothy C.} and Hatch, {Julie A.} and Smink, {Robert D.} and Sawin, {Henry S.} and Weber, {Frederic J.} and Brooks, {Helen B.} and Carins, {Rebecca F.} and Naip Tuna and Karnegis, {James N.} and Stevenson, {James E.} and Brykovsky, {Regina A.} and Linssen, {Mark A.} and Speech, {Jane C.} and Kurt Amplatz and Sanmarco, {Miguel E.} and Castaneda-Zuniga, {Wilfredo R.} and Hunter, {David W.} and Varco, {Richard L.} and Long, {John M.} and Matts, {John P.} and Fitch, {Laurie L.} and Johnson, {James W.} and Boen, {James R.} and Williams, {Stanley E.} and Phuong Nguyen and Hansen, {Betty J.} and Chalmers, {Thomas C.} and Bearman, {Jacob E.} and Cooper, {Gerald R.} and Greenhouse, {Samuel W.} and {Ward Kennedy}, J. and Paul Meier and Meinert, {Curtis L.} and Jeremiah Stamler and {Eugene Strandness}, D. and {Richard Conti}, C. and Titus, {Jack L.} and Edwards, {Jesse E.} and Griffith, {Lawrence S C}",
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language = "English (US)",
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pages = "S3--S10",
journal = "Journal of Cardiovascular Pharmacology",
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TY - JOUR

T1 - Program on the surgical control of the hyperlipidemias

T2 - 1994 report

AU - for the POSCH Group

AU - Buchwald, Henry

AU - Campos, Christian T.

AU - Leon, Arthur S.

AU - Rindal, Jean

AU - Hagen, Rebecka A.

AU - Campbell, Gilbert S.

AU - Pearce, Malcolm B.

AU - Bissett, Joseph K.

AU - Stuenkel, Meredith R.

AU - Yellin, Albert E.

AU - Edmiston Allan, W.

AU - Fujii, Dorothy C.

AU - Hatch, Julie A.

AU - Smink, Robert D.

AU - Sawin, Henry S.

AU - Weber, Frederic J.

AU - Brooks, Helen B.

AU - Carins, Rebecca F.

AU - Tuna, Naip

AU - Karnegis, James N.

AU - Stevenson, James E.

AU - Brykovsky, Regina A.

AU - Linssen, Mark A.

AU - Speech, Jane C.

AU - Amplatz, Kurt

AU - Sanmarco, Miguel E.

AU - Castaneda-Zuniga, Wilfredo R.

AU - Hunter, David W.

AU - Varco, Richard L.

AU - Long, John M.

AU - Matts, John P.

AU - Fitch, Laurie L.

AU - Johnson, James W.

AU - Boen, James R.

AU - Williams, Stanley E.

AU - Nguyen, Phuong

AU - Hansen, Betty J.

AU - Chalmers, Thomas C.

AU - Bearman, Jacob E.

AU - Cooper, Gerald R.

AU - Greenhouse, Samuel W.

AU - Ward Kennedy, J.

AU - Meier, Paul

AU - Meinert, Curtis L.

AU - Stamler, Jeremiah

AU - Eugene Strandness, D.

AU - Richard Conti, C.

AU - Titus, Jack L.

AU - Edwards, Jesse E.

AU - Griffith, Lawrence S C

PY - 1995

Y1 - 1995

N2 - The Program on the Surgical Control of the Hyperlipidemias (POSCH), a randomized clinical trial, tested the hypothesis that cholesterol modification induced by partial ileal bypass would favorably affect mortality and morbidity due to coronary heart disease (CHD). The study population consisted of 838 patients (417 in the control group and 421 in the surgery group) in four clinical centers, both men (90.7%) and women with an average age of 51 years who had survived a first myocardial infarction. The lipid changes in POSCH have been the most marked in any atherosclerosis intervention trial utilizing a single mode of intervention in addition to diet therapy. At 5 years, the surgery group, compared with the control group, had a 23.3 ± 1.0% (mean ± SE) lower total plasma cholesterol level (p < 0.0001), a 37.7 < 1.2% lower low-density lipoprotein cholesterol level (p < 0.0001), and a 4.3 ± 1.8% higher high-density lipoprotein cholesterol level (p = 0.02). For the combined end point of CHD mortality and confirmed nonfatal myocardial infarction, there was a 35.0% reduction in the surgery group (p < 0.001). Coronary artery bypass grafting was reduced in the surgery group by 62.0% (p < 0.0001) and percutaneous transluminal coronary angioplasty was reduced by 55.0% (p < 0.01). A comparison of baseline coronary arteriograms with those obtained at 3, 5, 7, and 10 years consistently showed less atherosclerosis disease progression (p < 0.001) and greater atherosclerosis disease regression at 5 and 7 years (p < 0.01) in the surgery group. At formal trial completion in July 1990, the overall mortality in the surgery subgroup with an ejection fraction of 50% or greater was 36.1% lower (p = 0.02). During subsequent follow-up, trends toward statistical significance for differences in both CHD and in overall mortality have become evident. The POSCH results provide strong support for beneficial clinical and arteriographie reduction of atherosclerosis progression after lipid modification by partial ileal bypass.

AB - The Program on the Surgical Control of the Hyperlipidemias (POSCH), a randomized clinical trial, tested the hypothesis that cholesterol modification induced by partial ileal bypass would favorably affect mortality and morbidity due to coronary heart disease (CHD). The study population consisted of 838 patients (417 in the control group and 421 in the surgery group) in four clinical centers, both men (90.7%) and women with an average age of 51 years who had survived a first myocardial infarction. The lipid changes in POSCH have been the most marked in any atherosclerosis intervention trial utilizing a single mode of intervention in addition to diet therapy. At 5 years, the surgery group, compared with the control group, had a 23.3 ± 1.0% (mean ± SE) lower total plasma cholesterol level (p < 0.0001), a 37.7 < 1.2% lower low-density lipoprotein cholesterol level (p < 0.0001), and a 4.3 ± 1.8% higher high-density lipoprotein cholesterol level (p = 0.02). For the combined end point of CHD mortality and confirmed nonfatal myocardial infarction, there was a 35.0% reduction in the surgery group (p < 0.001). Coronary artery bypass grafting was reduced in the surgery group by 62.0% (p < 0.0001) and percutaneous transluminal coronary angioplasty was reduced by 55.0% (p < 0.01). A comparison of baseline coronary arteriograms with those obtained at 3, 5, 7, and 10 years consistently showed less atherosclerosis disease progression (p < 0.001) and greater atherosclerosis disease regression at 5 and 7 years (p < 0.01) in the surgery group. At formal trial completion in July 1990, the overall mortality in the surgery subgroup with an ejection fraction of 50% or greater was 36.1% lower (p = 0.02). During subsequent follow-up, trends toward statistical significance for differences in both CHD and in overall mortality have become evident. The POSCH results provide strong support for beneficial clinical and arteriographie reduction of atherosclerosis progression after lipid modification by partial ileal bypass.

KW - Atherosclerosis

KW - Cholesterol

KW - Coronary heart disease

KW - Partial ileal bypass

KW - POSCH

KW - Randomized trial

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