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Odkazy a zdroje - Studie - AFCAPS/TexCAPS



AFCAPS/TexCAPS

Air Force/Texas Coronary Atherosclerosis Prevention Study

Author(s)
(a) Downs JR, Beere PA, Whitney E, Clearfield M, Weis S, Rochen J, Stein EA, Shapiro DR, Langendorfer A, Gotto AM Jr
(b) Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, Langendorfer A, Stein EA, Kruyer W, Gotto AM Jr, and the AFCAPS/TexCAPS Research Group

Title(s)
(a) Design & rationale of the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)
(b) Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. Results of AFCAPS/TexCAPS

Reference(s)
(a) Am J Cardiol 1997;80:287-93
(b) JAMA 1998;279:1615-22

Disease
Coronary atherosclerosis

Purpose
To evaluate the role of lovastatin in the primary prevention of acute major coronary events (MI, unstable angina pectoris, sudden cardiac death) in men and women with normal to mildly elevated total cholesterol and LDL cholesterol and low HDL cholesterol

Study design
Randomised, double-blind, placebo-controlled

Follow-up
5.2 years

Patients
6605 patients (3304 lovastatin, 3301 placebo), of which 5608 men, aged 45-73 years, and 997 women, aged 55-73 years, with normal or mildly elevated total and LDL cholesterol, low HDL cholesterol and with no clinically evident atherosclerotic cardiovascular disease

Treatment regimen
Lovastatin, 20-40 mg/day, based on LDL cholesterol values, or placebo

Concomitant therapy
Dietary counselling plus diet low in saturated fat and cholesterol

Results
Lovastatin reduced LDL cholesterol by 25% to 2.96 mmol/l and increased HDL cholesterol by 6% to 1.02 mmol/l. It also significantly reduced the incidence of first major acute coronary events (183 vs 116 first events, relative risk 0.63; p < 0.001), MI (95 vs 57 events, relative risk 0.60; p = 0.002), unstable angina (87 vs 60 first events, relative risk 0.68; p = 0.02), coronary revascularisation procedures (157 vs 106 procedures, relative risk 0.67; p = 0.001), coronary events (215 vs 163 events, relative risk 0.75; p = 0.006) and cardiovascular events (255 vs 194 events, relative risk 0.75; p = 0.003)