Reduction of myocardial reinfarction by the combined treatment with clofibrate and nicotinic acid

Carlson, Lars A.; Danielson, Mats; Ekberg, Ingvar; Klintemar, B.; Rosenhamer, G.

doi:10.1016/0021-9150(77)90201-5

Cited by 96 publications

(11 citation statements)

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“…These include single and multifactor trials, and primary and secondary diet and drug trials. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Two overview analyses have evaluated the effects of cholesterol lowering in clinical trials.20,21 They show that for every 1% cholesterol reduction a 2% CHD risk reduction is achieved. This 1:2 ratio is subsequently referred to as "the cholesterol benefit ratio."…”

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confidence: 99%

An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence.

Holme¹

1990

Circulation

224

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The primary aim of this study was to estimate the relation between cholesterol reduction and total mortality and coronary heart disease (CHD) incidence. Secondarily, the clinical issues of whether the efficacy of cholesterol lowering is dependent on the treatment modality, presence of CHD at baseline, or the simultaneous introduction of other interventions was explored. All randomized clinical intervention trials of cholesterol reduction were used in an overview analysis of total mortality rate and CHD incidence; analysis was performed with weighted linear regression. The trials include those that used primary and secondary intervention, diet and drugs, and single or multifactor design. Nineteen trials were analyzed for total mortality, and of the 19, 16 were analyzed for CHD incidence rate. Net difference in cholesterol change between study groups was used as the independent variable, and the three previously mentioned dichotomous design characteristics were used as additional independent variables. For every 1% reduction in cholesterol, an estimated 2.5% reduction in CHD incidence is indicated (95% CL: 1.1, 3.9). With regard to CHD drug trials tended toward better efficiency in cholesterol lowering than did dietary trials. With regard to total mortality, this efficiency was higher in secondary than in primary preventive trials. The efficiency was also somewhat dependent on the baseline cholesterol level. This study shows that cholesterol reduction is effective in lowering CHD incidence, but cholesterol reduction must be at least 8-9% to be effective in lowering total mortality. (Circulation 1990;82:1916-1924 In the prevention of early occurrence of coronary heart disease (CHD), various strategies have been implemented based on the three most important coronary risk factors, that is, total cholesterol, blood pressure, and cigarette smoking. The evidence of cholesterol lowering as an efficient method of CHD risk reduction has been tested through a series of intervention trials. These include single and multifactor trials, and primary and secondary diet and drug trials. address the question of whether the effect of cholesterol lowering is dependent on design characteristics such as primary and secondary or diet and drug intervention.The primary aim of this study was to estimate the relation between cholesterol reduction and total mortality and CHD incidence. Secondarily, the clinical issues of whether the efficacy of cholesterol lowering is dependent on the treatment modality, presence of CHD at baseline, or the simultaneous introduction of other interventions was explored.These questions are addressed through an overview analysis of all randomized controlled clinical trials involving designed cholesterol lowering. Total mortality and CHD incidence are the only end points under investigation. Trials with angiographic end points will not be discussed. MethodsThe criteria for inclusion of trials in this overview were 1) designed cholesterol lowering, 2) randomized design, and 3) total mortality or CHD incidence rep...

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confidence: 99%

An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence.

Holme¹

1990

Circulation

224

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“…Earlier trials of secondary prevention of IHD were less consistent (Medical Research Council Research Committee 1968, Leren 1966, but recent studies with potent lipid-lowering drugs are encouraging. In the study by Carlson et al (1977) the combination of clofibrate with nicotinic acid halved the incidence of non-fatal reinfarction, with a non-significant decrease in fatal events. The trial by Dorr et al (1978) involved 2278 hypercholesterolaemic men, a more informative design than that of other studies which included subjects with 'normal' lipid levels and those with various types of hyperlipidaemia.…”

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confidence: 97%

Hypothesis into Theory – the Development of Aetiological Concepts of Ischaemic Heart Disease: A Review

Lewis

1978

J R Soc Med

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“…Preliminary results are presented on the tentative classification of hyperlipoproteinaemia in tumour patients, using the lipid concentration threshold values advocated by Carlson et al (1977); an increased frequency of Type IV hyperlipoproteinaemia proved to be the most characteristic feature of tumour patients. The results are discussed in terms of the concept of the importance of lipid metabolic disturbances, primarily those due to ageing, in the genesis of the syndrome of "cancerophilia" (predisposition to cancer).…”

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confidence: 99%

“…Dilman & Bobrov, 1966;Feldman & Carter, 1971;Smethurst et al, 1975) (Dilman & Bobrov, 1966;Dilman et al, 1968;Tsyrlina et al, 1977;Berstein et al, 1978 (King, 1947), triglycerides were estimated according to the method of Carlson (1963), total :-lipoproteins (VLDL+ LDL) according to that of Ledvina & Coufalova (1960) and HDL-cholesterol was measured after removal of VLDL and LDL from the serum by precipitation wAith heparin and manganese chloride (Burstein & Scholnick, 1973). Threshold values of lipid concentrations for typing hyperlipoproteinaenmia wNere chosen according to the recommendations of Carlson et al (1977). Cases with cholesterol levels > 290 mg/100 ml and triglycerides < 180 mg/100 ml were referred to as Type Ila; cholesterol >290 mg/100 ml and triglycerides > 180 mg/100 ml-Type IIb, and cholesterol <290 mg/100 ml and triglycerides > 180 mg/100 ml-Type IV.…”

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confidence: 99%

Peculiarities of hyperlipidaemia in tumour patients

Dilman¹,

Berstein²,

Остроумова³

et al. 1981

Br J Cancer

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Reduction of myocardial reinfarction by the combined treatment with clofibrate and nicotinic acid

Cited by 96 publications

References 2 publications

An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence.

An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence.

Hypothesis into Theory – the Development of Aetiological Concepts of Ischaemic Heart Disease: A Review

Peculiarities of hyperlipidaemia in tumour patients

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