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Do the results of randomized clinical trials of cardiovascular drugs influence medical practice?

Article Abstract:

Publication of results of clinical trials using drugs to treat heart attack patients may influence the use of drugs by physicians. Two reports of clinical trials were published in 1988 that advocated the use of aspirin to prevent a first or second heart attack. Of 2,231 heart attack patients enrolled in the Survival and Ventricular Enlargement (SAVE) study who were followed over a three-year period, 16% used aspirin to prevent a first heart attack in Jan 1987, compared to 24% in Jan 1990. Approximately 39% of the patients used aspirin to prevent another heart attack before publication of the reports, compared to 72% after publication. Another study published in 1988 reported that diltiazem, a calcium channel blocker used to treat heart attack patients, had harmful side effects. Approximately 57% of the patients were treated with calcium channel blockers after a heart attack before publication of the study, compared with 33% after publication.

Health aspects, Cardiovascular diseases, Practice, Physicians, Medical professions, Clinical trials, Cardiovascular agents

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The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels

Article Abstract:

The cholesterol-lowering drug pravastatin may be beneficial in patients with coronary artery disease and moderately high cholesterol levels. Researchers in the Cholesterol and Recurrent Events (CARE) study randomized 4,159 women and men who had suffered a heart attack and had moderately high cholesterol levels to take pravastatin or placebo. Over the 5-year study, pravastatin lowered total cholesterol 28%, LDL cholesterol 28%, triglycerides 14% and raised HDL cholesterol 5%. It also reduced by more than 20% the incidence of subsequent heart attacks as well as the need for angioplasty or bypass surgery.

Evaluation, Heart attack, Hypercholesterolemia, Pravastatin

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Early intensive vs a delayed conservative simvastatin strategy in pateints with acute coronary syndromes: Phase Z of the A to Z trial

Article Abstract:

The early initiation of an intensive statin regimen with delayed inititation of a less intensive regimen in patients with acute coronary syndrome (ACS) is compared. Results reveal that among patients with ACS, the early initiation of an aggressive simvastatin regimen indicated a favorable trend toward reduction of major cardiovascular events.

United States, Diagnosis, Coronary heart disease, Dosage and administration, Simvastatin

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