Lipid Research Clinics-Coronary Primary Prevention Trial

An example and model for enlightened labelling policy is the US labelling for cholestyramine (Anon., 1995a). This is based on the results of the Lipid Research Clinics Coronary Primary Prevention Trial (LRC CPPT) (1984), and includes estimates of drug efficacy at four different dosing levels ... 

This break-out of values is much more informative to the vast majority of patients than the all-patient average. Variable dosing, which occurred as well in the placebo group, though with a somewhat different distribution than in the active group, had no evident effect on the two main endpoints of the LRC-CPPT, cholesterol reduction and coronary risk reduction (Lipid Research Clinics Coronary Primary Prevention Trial, 1984). 

Note The concentration of cholesterol in the placebo group (n = 1893) was independent of measured compliance (Lipid Research Clinics Coronary Primary Prevention Trial, 1984). 

Lipid Research Clinics Program. 1984. The lipid research clinics coronary primary prevention trial results. I. Reduction in incidence of coronary heart disease. JAMA 251, 351-364. 

Morris, D.L., Kritchevsky, S.B., and Davis, C.E. 1994. Serum carotenoids and coronary heart disease The lipid research clinics coronary primary prevention trial and follow-up study. JAMA 272, 1439-1441. 

Morris D, Kritchevsky SB, Davis CE. Serum carotenoids and coronary heart disease, The Lipid Research Clinics Coronary Primary Prevention Trial and Follow-up Study, JAMA I 994 272 1439-1441. 

The Lipid Research Clinics Coronary Primary Prevention Trial (L16, L17) is a landmark double-blind study in which cholestyramine, a bile acid se-questrant that is not absorbed from the gut, was used to lower plasma cholesterol. The investigators recruited 3806 men, with a Type II hyperlipoproteinemia phenotype and in good health, into the study. All were prescribed a cholesterol-lowering diet. Subjects were randomly assigned to a treatment group (who were prescribed 24 g cholestyramine daily) and a group with similar baseline characteristics who received an inactive placebo. A 19% lower incidence of coronary heart disease over a mean of 7.4 years in... 

Gordon DI, Trost DC, Hyde J, Whaley FS, Hannan PJ, Jacobs DR, Jr., Ekelund LG. Seasonal cholesterol cycles the Lipid Research Clinics Coronary Primary Prevention Trial placebo group. Circulation 1987 76 1224-31. 

Lipid Research Clinics Coronary Primary Prevention Trial results. II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA 1984 251 365-74. 

AECAPS/TexCAPS = Air ForceAexas Coronary Atherosclerosis Prevention Study (Downs et ah, 1998) Helsinki = The Helsinki Heart Study (Frick et al., 1 987) LRC-CPPT = The Lipid Research Clinics Coronary Primary Prevention Trial (insull et al., 1984) Oslo = The Oslo Study (Hjermann et ah, 1988) WOSCOPS = The West of Scotland Coronary Prevention Study (Shepherd et al., 1995) ALLHAT = Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial approximately 13-15% of patients had a history of coronary heart disease (CHD) events are CHD events only WHI = Women s Health initiative RRR = relative risk reduction ARR = absolute risk reduction NNT = number needed to treat NA = not available CEE = conjugated equine estrogen MPA = medroxyprogesterone acetate CARDS = Collaborative Atorvastatin Diabetes Study (presented at the 2004 American Diabetes Association meeting). 

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