atherosclerosis, cardiovascular disease, primary prevention, high risk patients
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2018 Jun 13. doi: 10.1056/NEJMoa1800389. [Epub ahead of print] Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients The Use of
Mediterranean diet supplemented with extra-virgin olive oil, or with mixed nuts
As Prevention, Primary
Is better Than
simple advice to reduce dietary fat
To reduce cardiovascular events (myocardial infarction, stroke, or cardiovascular death): medit. diet plus olive oil 3.8% VS medit. diet plus nuts 3.4% VS control group 4.4%
N Engl J Med. 2018 Aug 26. doi: 10.1056/NEJMoa1804988. [Epub ahead of print] Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, diabetes mellitus, type 2 The Use of
aspirin, 100 mg daily
As Treatment, Chronic
Is better Than
placebo
To reduce at 7.4 years cardiovascular events (8.5% VS 9.5% placebo), but it increased major bleeding (4% aspirin VS 3% placebo), most of the excess being gastrointestinal bleeding and other extracranial bleeding.
BMJ. 2014;349(iss):g4379 Meta-Analysis
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol The Use of
drug treatments targeted to increase high density lipoprotein: niacin, fibrates, and cholesteryl ester transfer protein (CETP) inhibitors
As Prevention, Primary
Is equal Than
placebo or no treatment
To modify cardiovascular events (all cause mortality, coronary heart disease mortality, non-fatal myocardial infarction, and stroke)
JAMA. 2014 Sep 17;312(11):1136-44 Systematic Review
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol, older patients The Use of
statins
As Prevention, Primary
Is undefined Than
no statin treatment
To reduce cardiovascular events. No RCT in patients older than 80 years was found
Lancet. 2002 Nov 23;360(9346):1623-30 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol, older patients The Use of
statins, pravastatin 40 mg/d
As Prevention, Primary
Is better Than
placebo
To to reduce at 3 years cardiovascular events: 14% pravastatine VS 16% placebo. Reduction was due to reduction in non-fatal myocardial infaction, no significant difference in stroke and death
J Am Coll Cardiol. 2013 Dec 3;62(22):2090-9 Meta-Analysis
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, older patients The Use of
statins
As Prevention, Primary
Is better Than
placebo
To reduce myocardial infarction (RR 0.60) and stroke (RR 0.76) but it did not reduced mortality (either total or cardiovascular)