Effective and safe modification of multiple atherosclerotic risk factors in patients with peripheral arterial disease

Rekha Garg, Marshall Elam, John R. Crouse, Kathryn B. Davis, J. Ward Kennedy, Debra Egan, J. Alan Herd, Donald B. Hunninghake, W. Craig Johnson, John B. Kostis, David S. Sheps, William B. Applegate

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Patients with peripheral arterial disease (PAD) are at an increased risk of cardiovascular mortality and morbidity and thus are an excellent group in whom to evaluate the feasibility and the effect of an aggressive multifactorial intervention on atherosclerotic vascular disease risk factors. The Arterial Disease Multiple Intervention Trial (ADMIT) was designed to determine the efficacy, safety, and compliance of an multifactorial therapy on selected atherosclerotic disease risk factors in patients with PAD. Methods: By a 2 x 2 x 2 factorial design, eligible participants (N = 468) were randomly assigned to low-dose warfarin, antioxidant vitamins, and niacin or its corresponding placebo, and followed up for 1 year. All participants were encouraged to use aspirin. Pravastatin was added to the drug regimen for those who needed to reduce LDL cholesterol to recommended levels. Results: Niacin increased HDL cholesterol levels by 30%, with the majority of effect achieved at a dosage of 500 mg twice daily. Warfarin had an anticoagulant effect. The antioxidant vitamins resulted in a significant increase in vitamin E, C, and beta-carotene plasma levels. Overall, compliance was high and few adverse effects were reported. Conclusions: ADMIT demonstrates that it is both feasible and safe to modify multiple atherosclerotic disease risk factors effectively with intensive combination therapy in patients with PAD.

Original languageEnglish (US)
Pages (from-to)792-803
Number of pages12
JournalAmerican Heart Journal
Volume140
Issue number5
DOIs
StatePublished - Jan 1 2000

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Peripheral Arterial Disease
Niacin
Warfarin
Vitamins
Antioxidants
Pravastatin
beta Carotene
Vitamin E
Vascular Diseases
LDL Cholesterol
Anticoagulants
HDL Cholesterol
Aspirin
Ascorbic Acid
Compliance
Placebos
Morbidity
Safety
Mortality
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Effective and safe modification of multiple atherosclerotic risk factors in patients with peripheral arterial disease. / Garg, Rekha; Elam, Marshall; Crouse, John R.; Davis, Kathryn B.; Kennedy, J. Ward; Egan, Debra; Herd, J. Alan; Hunninghake, Donald B.; Johnson, W. Craig; Kostis, John B.; Sheps, David S.; Applegate, William B.

In: American Heart Journal, Vol. 140, No. 5, 01.01.2000, p. 792-803.

Research output: Contribution to journalArticle

Garg, R, Elam, M, Crouse, JR, Davis, KB, Kennedy, JW, Egan, D, Herd, JA, Hunninghake, DB, Johnson, WC, Kostis, JB, Sheps, DS & Applegate, WB 2000, 'Effective and safe modification of multiple atherosclerotic risk factors in patients with peripheral arterial disease', American Heart Journal, vol. 140, no. 5, pp. 792-803. https://doi.org/10.1067/mhj.2000.110090
Garg, Rekha ; Elam, Marshall ; Crouse, John R. ; Davis, Kathryn B. ; Kennedy, J. Ward ; Egan, Debra ; Herd, J. Alan ; Hunninghake, Donald B. ; Johnson, W. Craig ; Kostis, John B. ; Sheps, David S. ; Applegate, William B. / Effective and safe modification of multiple atherosclerotic risk factors in patients with peripheral arterial disease. In: American Heart Journal. 2000 ; Vol. 140, No. 5. pp. 792-803.
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