(Circulation. 1998;97:1217-1220.)
© 1998 American Heart Association, Inc.
Meeting Highlights
Highlights of the 70th Scientific Sessions of the American Heart Association
James J. Ferguson, MD
From St Luke's Episcopal Hospital, Texas Heart Institute, Baylor
College of Medicine, and the University of Texas Health Science Center at
Houston.
The
following trials were presented at the 70th Scientific Sessions
of the American Heart Association, November 10–13, 1997, in Orlando,
Fla.
Lipid-Lowering Therapy
The Trial: AFCAPS/TEXCAPS
Presenter: Antonio Gotto, MD, Cornell University,
New York, NY.
The study: A randomized, placebo-controlled trial of the
HMG-CoA reductase inhibitor lovastatin in 6605
patients with average LDL cholesterol (130 to 190 mg/dL)
and relatively low HDL (<50 mg/dL), with an HDL/LDL ratio of <0.5. No
patients had clinical evidence of coronary artery disease.
Patients were randomized to placebo or lovastatin (mean
dose, 30 mg) and followed up. The primary end point of the trial was
the new development of unstable angina, fatal or nonfatal MI, or sudden
cardiac death. The study was stopped when the result crossed the
prespecified stopping boundaries after a total of 267 events.
The results: Overall, treatment with lovastatin
resulted in a 36% relative decrease in the incidence of
primary-end-point events. In the placebo group, the total number of
primary-end-point events at long-term follow-up (
5 years) was 182,
compared with 105 in the lovastatin group.
Lovastatin therapy was associated with a relative decrease
of 34% in new unstable angina admissions, 35% in fatal or nonfatal
MI, and 33% in revascularization procedures. The
degree of benefit was independent of the absolute level of LDL.
Summary: In men and women free of clinical signs of
cardiovascular disease, with average total
cholesterol and LDL and low HDL, treatment with
lovastatin results in a significant decrease in the
incidence of new cardiovascular events.
The Trial: LIPID
Presenter: Andrew Tonkin, MD, University . . . [Full Text of this Article]
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