Key result
Stepped-care pravastatin and nicotinic acid achieves target LDL in ~94% of normolipidemic CHD patients.
Why the study?
The efficacy of combination lipid-lowering drug therapy has not been well studied in patients with coronary heart disease and average lipid levels previously considered normolipidemic.
Does stepped-care combination lipid-lowering therapy improve lipid profiles in patients with coronary heart disease and average baseline lipid levels?
Population
91 patients with coronary heart disease and total cholesterol less than 6.4 mmol/L
Comparison
Stepped-care combination lipid-lowering therapy vs usual care (placebo)
Design
Randomized, placebo-controlled trial
Follow-up
2.5 years
Authors
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Supports stepped-care combination therapy for LDL goal attainment in normolipidemic CHD; extends evidence to average-lipid populations.
RCT (n=91)
Yes
Does stepped-care combination lipid-lowering therapy improve lipid profiles in patients with coronary heart disease and average baseline lipid levels?
Combination lipid-lowering therapy is often necessary and effective to reach LDL cholesterol goals in normolipidemic patients with coronary heart disease.
Richard C. Pasternak (1996) conducted an RCT in Coronary heart disease with average lipid levels (n=91). Stepped-care multidrug therapy (pravastatin, nicotinic acid, cholestyramine, gemfibrozil) vs. Usual care / placebo was evaluated on Changes in low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels. Stepped-care combination therapy with pravastatin and nicotinic acid enabled 94% of normolipidemic patients with coronary heart disease to reach target LDL cholesterol levels of ≤2.6 mmol/L.
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