Hypolipidemic Drugs in Coronary Artery Disease
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TO THE EDITOR:
I read with interest the article by Pasternak and colleagues on behalf of the Harvard Atherosclerosis Reversibility Project (HARP) Study Group [1]. I was disappointed in the authors' discussion of the article by Stein and colleagues [2], which compared simvastatin with cholestyramine. Pasternak and coworkers stated that combination therapy with simvastatin and cholestyramine decreased total and LDL cholesterol levels by only 15% and 21%, respectively. In fact, these numbers were related to the reduction induced only by the cholestyramine resin; simvastatin alone in dosages of 20 mg/d and 40 mg/d reduced the total cholesterol level by 26% and 33%, respectively. The corresponding reductions in LDL cholesterol levels were 32% and 40%, respectively.
Furthermore, Stein and colleagues' study was a comparative, randomized, open-label, 12-week multicenter trial; it was not a study of the combination of cholestyramine and simvastatin, as stated by Pasternak and associates.
George B. Bittar, MD
Nasser Smith Pinkerton Cardiology, Inc.; Terre Haute, IN 47802
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
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