RELATIONSHIP BETWEEN PLASMA LDL CONCENTRATIONS DURING TREATMENT WITH PRAVASTATIN AND RECURRENT CORONARY EVENTS IN THE CHOLESTEROL AND RECURRENT EVENTS TRIAL

Citation
Fm. Sacks et al., RELATIONSHIP BETWEEN PLASMA LDL CONCENTRATIONS DURING TREATMENT WITH PRAVASTATIN AND RECURRENT CORONARY EVENTS IN THE CHOLESTEROL AND RECURRENT EVENTS TRIAL, Circulation, 97(15), 1998, pp. 1446-1452
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Peripheal Vascular Diseas",Hematology,"Cardiac & Cardiovascular System
Journal title
ISSN journal
0009-7322
Volume
97
Issue
15
Year of publication
1998
Pages
1446 - 1452
Database
ISI
SICI code
0009-7322(1998)97:15<1446:RBPLCD>2.0.ZU;2-2
Abstract
Background-Although LDL lowering has been shown to reduce recurrent co ronary events in patients with coronary heart disease, little direct i nformation is available on the extent of LDL lowering required to achi eve this outcome. Methods and Results-The Cholesterol and Recurrent Ev ents (CARE) trial compared pravastatin and placebo in patients who had experienced myocardial infarction CMI) who had average concentrations of total cholesterol <240 mg/dL (baseline meant 209 mg/dL) and LDL ch olesterol (LDL) 115 to 174 mg/dL (mean, 139 mg/dL). Pravastatin reduce d coronary death or recurrent MI by 24%. In multivariate analysis, the LDL concentration achieved during follow-up was a significant, althou gh nonlinear, predictor of the coronary event rate (P=.007), whereas t he extent of LDL reduction was not significant, whether expressed as a n absolute amount (P=.97) or a percentage (P=.76). The coronary event rate declined as LDL decreased during follow-up from 174 to approximat e to 125 mg/dL, but no further decline was seen in the LDL range from 125 to 71 mg/dL, In multivariate analysis, triglyceride but not HDL co ncentrations during follow-up were weakly but significantly associated with the coronary event rate. Conclusions-The LDL concentrations achi eved during treatment with pravastatin or placebo were associated with reduction in coronary events down to an LDL concentration of approxim ate to 125 mg/dL. LDL concentrations <125 mg/dL during treatment were not associated with further benefit, Absolute or percentage reduction in LDL had little relationship to coronary events.