TY  - CHAP
M1  - Book, Section
TI  - Therapeutic Effects of Lowering Cholesterol
A1  - Blaha, Michael J.
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
A2  - McQuaid, Kenneth R.
Y1  - 2022
N1  - 
T2  - Current Medical Diagnosis & Treatment 2022
AB  - Reducing  cholesterol  levels  in  healthy  middle-aged  men  without  coronary  heart  disease  (CHD)  (in  primary  prevention  studies)  reduces  risk  in  direct  proportion  to  the  reduction  in  LDL  cholesterol.  Treated  adults  have  clinically  important  reductions  in  the  rates  of  myocardial  infarctions,  new  cases  of  angina,  need  for  coronary  artery  bypass  or  other  revascularization  procedures,  peripheral  artery  disease,  and  stroke.  The  West  of  Scotland  Study  showed  a  31%  decrease  in  myocardial  infarctions  in  middle-aged  men  treated  with  pravastatin  compared  with  placebo.  The  Air  Force/Texas  Coronary  Atherosclerosis  Prevention  Study  (AFCAPS/TexCAPS)  study  showed  similar  results  with  lovastatin.  As  with  any  primary  prevention  interventions,  large  numbers  of  healthy  patients  need  to  be  treated  to  prevent  a  single  event.  The  numbers  of  patients  needed  to  treat  (NNT)  to  prevent  one  nonfatal  myocardial  infarction  or  one  coronary  artery  disease  death  in  these  two  studies  were  46  and  50,  respectively.  The  Anglo-Scandinavian  Cardiac  Outcomes  Trial  (ASCOT)  study  of  atorvastatin  in  persons  with  hypertension  and  other  risk  factors  but  without  CHD  demonstrated  a  36%  reduction  in  CHD  events.  The  Justification  for  the  Use  of  Statins  in  Prevention:  An  Intervention  Trial  Evaluating  Rosuvastatin  (JUPITER)  study  showed  a  44%  reduction  in  a  combined  end  point  of  myocardial  infarction,  stroke,  revascularization,  hospitalization  for  unstable  angina,  or  death  from  cardiovascular  causes  in  both  men  and  women.  The  NNT  for  1  year  to  prevent  one  event  was  169.  The  Heart  Outcomes  Prevention  Evaluation  (HOPE-3)  trial  of  rosuvastatin  showed  a  24%  reduction  in  cardiovascular  events.  The  NNT  over  5.6  years  was  91.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/23
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1184162720
ER  -