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Odkazy a zdroje - Studie - CARE



CARE

Cholesterol And Recurrent Events

Author(s)
(a) Sacks FM, Pfeffer MA, Moyé L, Brown LE, Hamm P, Cole TG, Hawkins CM, Braunwald E
(b) Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutherford JD, Cole TG, Brown L, Warnica JW, Arnold JMO, Wun C-C, Davis BR, Braunwald E

Title(s)
(a) Rationale and design of a secondary prevention trial of lowering normal plasma cholesterol levels after acute myocardial infarction: the Cholesterol and Recurrent Events trial (CARE)
(b) The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels

Reference(s)
(a) Am J Cardiol 1991; 68:1436-46
(b) N Engl J Med 1996;335:1001-9

Disease
Previous AMI

Purpose
To assess the effect of pravastatin on fatal coronary events and nonfatal AMI in patients with average cholesterol levels

Study design
Randomised, double-blind, placebo-controlled

Follow-up
≥ 5 years

Patients
4159 patients, aged 21-75 years, who have had AMI 3-20 months before randomisation, with plasma total cholesterol < 240 mg/dl, LDL cholesterol 115-174 mg/dl and triglycerides ≤ 350 mg/dl

Treatment regimen
Pravastatin, 40 mg once daily, or placebo

Concomitant therapy
All previously prescribed medication continued. If LDL increased, dietary counselling and also cholestyramine

Results
The frequency of fatal coronary events plus nonfatal infarctions was reduced by 24% in the pravastatin-treated patients (p = 0.003). The frequency of CABG was reduced by 26% and the need for coronary angioplasty by 23% by pravastatin (p = 0.005 and p = 0.01, respectively). There was no reduction in coronary events among patients with baseline LDL cholesterol < 125 mg/dl

Comments
This study has been the basis for a number of publications. A small selection of references:
Lipid levels and size
– Pfeffer MA, J Am Coll Cardiol 1999;33:125–30
– Campos H, JAMA 2001;286:1468–74 Stroke
– Plehn JF, Circulation 1999;99:216–23