CARE研究课件（PPT 17页）.ppt

Fatal CHD or Nonfatal Myocardial Infarction (Primary Endpoint) CABG/PTCA/Combined 26% reduction (p=0.005) PTCA 23% reduction (p=0.01) Combined CABG/PTCA 27% risk reduction (p0.001) Other: Stroke 31% reduction (p=0.03) The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels Frank M. Sacks, M.D., Marc A. Pfeffer, M.D., Ph.D., Lemuel A. Moye, M.D., Ph.D., Jean L. Rouleau, M.D., J. Malcolm O. Arnold, M.D., Chuan-Chuan Wun, Ph.D., Barry Davis, M.D., Ph.D., Eugene Braunwald, M.D., for the Cholesterol and Recurrent Events Trial Investigators N Engl J Med 1996; 335:1001-9 CARE - Study Design Secondary prevention of CHD 80 centers in the US and Canada 4159 men and women aged 21 to 75 enrolled 3 to 20 months post-MI Total-C 240; LDL-C between 115 and 174; Triglycerides 350 mg/dL 5 yr Treatment with Pravastatin 40 mg vs. placebo Sacks, F. et al, N Engl J Med 1996; 335:1001-9 CARE - Study Endpoints Primary: CHD death or nonfatal MI Secondary: CHD death Tertiary: Total Mortality Others: Fatal MI, nonfatal MI, PTCA, CABG, Stroke Sacks, F. et al, N Engl J Med 1996; 335:1001-9 CARE - Baseline Characteristics 86% male; 14% female Mean age 59 ± 9 years 93% white 21% current smoker 42% hypertensive 14% diabetic Sacks, F. et al, N Engl J Med 1996; 335:1001-9 CARE - Baseline Characteristics Mean 10 ± 5 months post-MI 54% had prior PTCA / CABG 83% taking aspirin 41% taking b-blockers 40% taking calcium antagonists 15% taking ACEIs Sacks, F. et al, N Engl J Med 1996; 335:1001-9 Lipids at Baseline Sacks, F. et al, N Engl J Med 1996; 335:1001-9 Plasma Lipid Placebo Pravastatin (n=2078) (n=2081) Cholesterol (mg/dL) Total 209 209 VLDL 27 27 LDL 139 139 HDL 39 39 Triglycerides (mg/dL) 155 156 Percent LDL Reduction on Treatment P 0.001 for all comparisons Sacks, F. et al, N Engl J Med 1996; 335:1001-9 Sacks, F. et al, N Engl J Med 1996; 335:1001-9 24% Risk Reduction p = 0.003 C