Application of the National Cholesterol Education joint European treatment criteria and clinical benefit in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)

Antonio M. Gotto, E. Whitney, E. A. Stein, D. R. Shapiro, M. Clearfield, S. Weis, J. Y. Jou, A. Langendörfer, P. A. Beere, D. J. Watson, John R Downs, J. S. De Cani

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Aims The Air Force/Texas Coronary Atherosclerosis Prevention Study reported that diet with lovastatin, 20-40 mg daily, reduced the risk for a first coronary event by 37%. Because only 17% of this cohort would have qualified for drug therapy according to current U.S. guidelines, we assessed clinical benefit by risk categories. Methods and Results The main outcome measures were event rates of first acute major coronary events stratified by National Cholesterol Education Program and European criteria and target goal. Both those who would and would not be eligible for drug therapy, according to National Cholesterol Education Program guidelines, benefited from intervention. As expected, drug-eligible participants (event rate: lovastatin 1%/year, placebo 1.87%/year [relative risk 0.53, 95% confidence interval: 0.33, 0.84]) were at greater absolute risk for acute major coronary events than non-eligible participants (lovastatin 0.62%/year, placebo 0.93%/ year [relative risk 0.67, 95% confidence interval: 0.51, 0.88]). Similar results were found using European guidelines for coronary risk management. Treatment to a target goal suggested a non-significant trend to greater benefit. Conclusions The consistent relative benefit across risk categories suggests that it may be possible to improve identification of at-risk persons who would benefit from primary prevention, and to recommend appropriate goals of such treatment. (C) 2000 The European Society of Cardiology.

Original languageEnglish (US)
Pages (from-to)1627-1633
Number of pages7
JournalEuropean Heart Journal
Volume21
Issue number19
DOIs
StatePublished - 2000
Externally publishedYes

Fingerprint

Coronary Artery Disease
Lovastatin
Cholesterol
Air
Education
Guidelines
Placebos
Confidence Intervals
Therapeutics
Drug Therapy
Risk Management
Primary Prevention
Outcome Assessment (Health Care)
Diet
Pharmaceutical Preparations

Keywords

  • Atherosclerosis
  • Guidelines
  • Lovastatin
  • Primary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Application of the National Cholesterol Education joint European treatment criteria and clinical benefit in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). / Gotto, Antonio M.; Whitney, E.; Stein, E. A.; Shapiro, D. R.; Clearfield, M.; Weis, S.; Jou, J. Y.; Langendörfer, A.; Beere, P. A.; Watson, D. J.; Downs, John R; De Cani, J. S.

In: European Heart Journal, Vol. 21, No. 19, 2000, p. 1627-1633.

Research output: Contribution to journalArticle

Gotto, AM, Whitney, E, Stein, EA, Shapiro, DR, Clearfield, M, Weis, S, Jou, JY, Langendörfer, A, Beere, PA, Watson, DJ, Downs, JR & De Cani, JS 2000, 'Application of the National Cholesterol Education joint European treatment criteria and clinical benefit in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)', European Heart Journal, vol. 21, no. 19, pp. 1627-1633. https://doi.org/10.1053/euhj.2000.2288
Gotto, Antonio M. ; Whitney, E. ; Stein, E. A. ; Shapiro, D. R. ; Clearfield, M. ; Weis, S. ; Jou, J. Y. ; Langendörfer, A. ; Beere, P. A. ; Watson, D. J. ; Downs, John R ; De Cani, J. S. / Application of the National Cholesterol Education joint European treatment criteria and clinical benefit in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). In: European Heart Journal. 2000 ; Vol. 21, No. 19. pp. 1627-1633.
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AU - Gotto, Antonio M.

AU - Whitney, E.

AU - Stein, E. A.

AU - Shapiro, D. R.

AU - Clearfield, M.

AU - Weis, S.

AU - Jou, J. Y.

AU - Langendörfer, A.

AU - Beere, P. A.

AU - Watson, D. J.

AU - Downs, John R

AU - De Cani, J. S.

PY - 2000

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N2 - Aims The Air Force/Texas Coronary Atherosclerosis Prevention Study reported that diet with lovastatin, 20-40 mg daily, reduced the risk for a first coronary event by 37%. Because only 17% of this cohort would have qualified for drug therapy according to current U.S. guidelines, we assessed clinical benefit by risk categories. Methods and Results The main outcome measures were event rates of first acute major coronary events stratified by National Cholesterol Education Program and European criteria and target goal. Both those who would and would not be eligible for drug therapy, according to National Cholesterol Education Program guidelines, benefited from intervention. As expected, drug-eligible participants (event rate: lovastatin 1%/year, placebo 1.87%/year [relative risk 0.53, 95% confidence interval: 0.33, 0.84]) were at greater absolute risk for acute major coronary events than non-eligible participants (lovastatin 0.62%/year, placebo 0.93%/ year [relative risk 0.67, 95% confidence interval: 0.51, 0.88]). Similar results were found using European guidelines for coronary risk management. Treatment to a target goal suggested a non-significant trend to greater benefit. Conclusions The consistent relative benefit across risk categories suggests that it may be possible to improve identification of at-risk persons who would benefit from primary prevention, and to recommend appropriate goals of such treatment. (C) 2000 The European Society of Cardiology.

AB - Aims The Air Force/Texas Coronary Atherosclerosis Prevention Study reported that diet with lovastatin, 20-40 mg daily, reduced the risk for a first coronary event by 37%. Because only 17% of this cohort would have qualified for drug therapy according to current U.S. guidelines, we assessed clinical benefit by risk categories. Methods and Results The main outcome measures were event rates of first acute major coronary events stratified by National Cholesterol Education Program and European criteria and target goal. Both those who would and would not be eligible for drug therapy, according to National Cholesterol Education Program guidelines, benefited from intervention. As expected, drug-eligible participants (event rate: lovastatin 1%/year, placebo 1.87%/year [relative risk 0.53, 95% confidence interval: 0.33, 0.84]) were at greater absolute risk for acute major coronary events than non-eligible participants (lovastatin 0.62%/year, placebo 0.93%/ year [relative risk 0.67, 95% confidence interval: 0.51, 0.88]). Similar results were found using European guidelines for coronary risk management. Treatment to a target goal suggested a non-significant trend to greater benefit. Conclusions The consistent relative benefit across risk categories suggests that it may be possible to improve identification of at-risk persons who would benefit from primary prevention, and to recommend appropriate goals of such treatment. (C) 2000 The European Society of Cardiology.

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