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At five years, the combined primary end point of cardiac death and non-fatal myocardial infarction occurred in 17.3% versus 21.7% in the placebo group.  Acute coronary events reduced by 11% with gemfibrozil for every 5 mg/dL rise in HDL-C, but the reduction was independent of changes in LDL-C and triglyceride levels.  
At five years, the combined primary end point of cardiac death and non-fatal myocardial infarction occurred in 17.3% versus 21.7% in the placebo group.  Acute coronary events reduced by 11% with gemfibrozil for every 5 mg/dL rise in HDL-C, but the reduction was independent of changes in LDL-C and triglyceride levels.  
* Conclusion: Low HDL-C levels strongly and independently predict the occurrence of coronary events which were reduced by treatment with gemfibrozil.<ref name="pmid18356553">{{cite journal |author=Robins SJ, Collins D, Nelson JJ, Bloomfield HE, Asztalos BF |title=Cardiovascular events with increased lipoprotein-associated phospholipase A(2) and low high-density lipoprotein-cholesterol: the Veterans Affairs HDL Intervention Trial |journal=Arterioscler. Thromb. Vasc. Biol. |volume=28 |issue=6 |pages=1172–8 |year=2008 |month=June |pmid=18356553 |doi=10.1161/ATVBAHA.107.160739 |url=}}</ref><ref name="pmid18078862">{{cite journal |author=Asztalos BF, Collins D, Horvath KV, Bloomfield HE, Robins SJ, Schaefer EJ |title=Relation of gemfibrozil treatment and high-density lipoprotein subpopulation profile with cardiovascular events in the Veterans Affairs High-Density Lipoprotein Intervention Trial |journal=Metab. Clin. Exp. |volume=57 |issue=1 |pages=77–83 |year=2008 |month=January |pmid=18078862 |pmc=2194640 |doi=10.1016/j.metabol.2007.08.009 |url=}}</ref><ref name="pmid20855565">{{cite journal |author=Peloso GM, Demissie S, Collins D, ''et al.'' |title=Common genetic variation in multiple metabolic pathways influences susceptibility to low HDL-cholesterol and coronary heart disease |journal=J. Lipid Res. |volume=51 |issue=12 |pages=3524–32 |year=2010 |month=December |pmid=20855565 |pmc=2975725 |doi=10.1194/jlr.P008268 |url=}}</ref><ref name="pmid17335828">{{cite journal |author=Robins SJ, Collins D, McNamara JR, Bloomfield HE |title=Body weight, plasma insulin, and coronary events with gemfibrozil in the Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT) |journal=Atherosclerosis |volume=196 |issue=2 |pages=849–55 |year=2008 |month=February |pmid=17335828 |doi=10.1016/j.atherosclerosis.2007.01.029 |url=}}</ref>
* Conclusion: Low HDL-C levels strongly and independently predict the occurrence of coronary events which were reduced by treatment with gemfibrozil.<ref name="pmid18356553">{{cite journal |author=Robins SJ, Collins D, Nelson JJ, Bloomfield HE, Asztalos BF |title=Cardiovascular events with increased lipoprotein-associated phospholipase A(2) and low high-density lipoprotein-cholesterol: the Veterans Affairs HDL Intervention Trial |journal=Arterioscler. Thromb. Vasc. Biol. |volume=28 |issue=6 |pages=1172–8 |year=2008 |month=June |pmid=18356553 |doi=10.1161/ATVBAHA.107.160739 |url=}}</ref><ref name="pmid18078862">{{cite journal |author=Asztalos BF, Collins D, Horvath KV, Bloomfield HE, Robins SJ, Schaefer EJ |title=Relation of gemfibrozil treatment and high-density lipoprotein subpopulation profile with cardiovascular events in the Veterans Affairs High-Density Lipoprotein Intervention Trial |journal=Metab. Clin. Exp. |volume=57 |issue=1 |pages=77–83 |year=2008 |month=January |pmid=18078862 |pmc=2194640 |doi=10.1016/j.metabol.2007.08.009 |url=}}</ref><ref name="pmid20855565">{{cite journal |author=Peloso GM, Demissie S, Collins D, ''et al.'' |title=Common genetic variation in multiple metabolic pathways influences susceptibility to low HDL-cholesterol and coronary heart disease |journal=J. Lipid Res. |volume=51 |issue=12 |pages=3524–32 |year=2010 |month=December |pmid=20855565 |pmc=2975725 |doi=10.1194/jlr.P008268 |url=}}</ref><ref name="pmid17335828">{{cite journal |author=Robins SJ, Collins D, McNamara JR, Bloomfield HE |title=Body weight, plasma insulin, and coronary events with gemfibrozil in the Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT) |journal=Atherosclerosis |volume=196 |issue=2 |pages=849–55 |year=2008 |month=February |pmid=17335828 |doi=10.1016/j.atherosclerosis.2007.01.029 |url=}}</ref>


===AIM-HIGH Trial===
===AIM-HIGH Trial===

Revision as of 13:27, 17 April 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]; Raviteja Guddeti, M.B.B.S. [3]

Landmark Trials

VA-HIT Trial

  • Objective: To conclude if changes in plasma lipid levels due to gemfibrozil is the cause for reduction in major cardiovascular events in VA-HIT trial.
  • Method: VA-HIT (Veterans Affairs HDL Intervention Trial) trial is a multicentered, randomized, double-blinded, placebo-controlled trial wherein 2531 patients with CAD along with LDL levels ≤140 mg/dL (mean 111 mg/dL) and HDL ≤40 mg/dL (mean 32 mg/dL) were randomly assigned to treatment with gemfibrozil or placebo.
  • Results: At one year the following findings were noted in the group treated with gemfibrozil:
    • Mean HDL-C level was higher by 6%
    • 31% lower mean TG concentration
    • Mean total cholesterol was 4% lower

At five years, the combined primary end point of cardiac death and non-fatal myocardial infarction occurred in 17.3% versus 21.7% in the placebo group. Acute coronary events reduced by 11% with gemfibrozil for every 5 mg/dL rise in HDL-C, but the reduction was independent of changes in LDL-C and triglyceride levels.

  • Conclusion: Low HDL-C levels strongly and independently predict the occurrence of coronary events which were reduced by treatment with gemfibrozil.[1][2][3][4]

AIM-HIGH Trial

References

  1. ↑ Robins SJ, Collins D, Nelson JJ, Bloomfield HE, Asztalos BF (2008). "Cardiovascular events with increased lipoprotein-associated phospholipase A(2) and low high-density lipoprotein-cholesterol: the Veterans Affairs HDL Intervention Trial". Arterioscler. Thromb. Vasc. Biol. 28 (6): 1172–8. doi:10.1161/ATVBAHA.107.160739. PMID 18356553. Unknown parameter |month= ignored (help)
  2. ↑ Asztalos BF, Collins D, Horvath KV, Bloomfield HE, Robins SJ, Schaefer EJ (2008). "Relation of gemfibrozil treatment and high-density lipoprotein subpopulation profile with cardiovascular events in the Veterans Affairs High-Density Lipoprotein Intervention Trial". Metab. Clin. Exp. 57 (1): 77–83. doi:10.1016/j.metabol.2007.08.009. PMC 2194640. PMID 18078862. Unknown parameter |month= ignored (help)
  3. ↑ Peloso GM, Demissie S, Collins D; et al. (2010). "Common genetic variation in multiple metabolic pathways influences susceptibility to low HDL-cholesterol and coronary heart disease". J. Lipid Res. 51 (12): 3524–32. doi:10.1194/jlr.P008268. PMC 2975725. PMID 20855565. Unknown parameter |month= ignored (help)
  4. ↑ Robins SJ, Collins D, McNamara JR, Bloomfield HE (2008). "Body weight, plasma insulin, and coronary events with gemfibrozil in the Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT)". Atherosclerosis. 196 (2): 849–55. doi:10.1016/j.atherosclerosis.2007.01.029. PMID 17335828. Unknown parameter |month= ignored (help)

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