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