Ignite Creation Date:
2024-05-05 @ 4:37 PM
Last Modification Date:
2024-10-26 @ 9:22 AM
Study NCT ID:
NCT00283335
Status:
COMPLETED
Last Update Posted:
2015-10-21
First Post:
2006-01-25
Brief Title:
The VA HDL Intervention Trial HIT Secondary Prevention of Coronary Heart Disease in Men With Low HDL-Cholesterol and Desirable LDL-Cholesterol
Sponsor:
VA Office of Research and Development
Organization:
VA Office of Research and Development
Study Overview
Official Title:
CSP 363 - The VA HDL Intervention Trial HIT Secondary Prevention of Coronary Heart Disease in Men With Low HDL-Cholesterol and Desirable LDL-Cholesterol
Status:
COMPLETED
Status Verified Date:
2015-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
HIT
Brief Summary:
This was a double-blind randomized trial comparing 1200 mg per day of gemfibrozil with placebo in 2531 men with coronary heart disease an HDL-C of 40mgdl or less an LDL-C of 140 mgdl or less and triglycerides of 300mgdl or less The primary outcome was nonfatal myocardial infarctionMI or death from coronary causes The median follow-up was 51 years There was a risk reduction of 22 in the primary outcome p0006 and 24 risk reduction in the combined endpoint of stroke MI and CHD death The rate of events was reduced by raising HDL-C and lowering triglycerides without lowering LDL-C N Engl J Med 1999341410-418
Detailed Description:
Primary Hypothesis
To determine if drug treatment aimed at raising HDL-cholesterol and lowering triglycerides will reduce the rate of heart attack and death in veterans with coronary heart disease CHD and a specific lipid profile characterized by normal levels of LDL-cholesterol and low levels of HDL-cholesterol
Secondary Hypotheses
To determine the effect of treatment on total mortality unstable angina CABG PTCA strokes and PVD and to determine whether there is an association between changes in plasma lipid levels and outcomes
Primary Outcomes
Myocardial infarction MI silent MI and CHD death
Interventions
Gemfibrozil 1200 mg per day versus matching placebo
Study Abstract
A double-blind trial was conducted comparing gemfibrozil with placebo in 2531 men with coronary heart disease an HDL cholesterol level of 40 mgdL or less and an LDL cholesterol level of 140 mgdL or less
The median follow-up was 51 years At one year the mean HDL was 6 higher the mean triglyceride were 31 lower and the mean total cholesterol was 4 lower in the gemfibrozil group than in the placebo group LDL levels did not differ between the groups
A primary event MI or death occurred in 275 of the 1267 placebo patients 217 and in 219 of the 1264 gemfibrozil patients 173 The overall reduction in the risk of an event was 44 percentage points and the reduction in relative risk was 22 95 confidence interval 7 to 35 p0006 A 24 relative risk reduction occurred in the combined outcome of death from coronary heart disease nonfatal myocardial infarction and stroke p0001 Gemfibrozil therapy resulted in a significant reduction in the risk of major cardiovascular events in patients with coronary disease whose primary lipid abnormality was a low HDL cholesterol level The findings suggest that the rate of coronary events is reduced by raising HDL cholesterol levels and lowering levels of triglycerides without lowering LDL cholesterol levels
The major findings were published in the New England Journal of Medicine in August 1999 A paper on lipid screening was published in the Journal of Clinical Epidemiology in July 1999 and one on clinical implications was published in the European Heart Journal Our cost analysis shows that gemfibrozil therapy is highly cost-effective if not cost-saving thus providing a strong rationale for incorporating results into clinical practice A manuscript about lipids as predictors of endpoints was published in JAMA in March 2001 Another paper on stroke was published in Circulation in June 2001 Dr Robins presented data on diabetics in November 2000 at the AHA A paper on cost-effectiveness was published in the Archives of Internal Medicine in January 2002 A manuscript on diabetes has been accepted by the Archives of Internal Medicine
A NHLBI grant for continuing analysis has been funded for two years Other papers in progress include homocysteines in diabetics fasting plasma insulin as a predictor of outcome and the effect of lipoprotein subclass particle size on coronary events
To determine if drug treatment aimed at raising HDL-cholesterol and lowering triglycerides will reduce the rate of heart attack and death in veterans with coronary heart disease CHD and a specific lipid profile characterized by normal levels of LDL-cholesterol and low levels of HDL-cholesterol
Secondary Hypotheses
To determine the effect of treatment on total mortality unstable angina CABG PTCA strokes and PVD and to determine whether there is an association between changes in plasma lipid levels and outcomes
Primary Outcomes
Myocardial infarction MI silent MI and CHD death
Interventions
Gemfibrozil 1200 mg per day versus matching placebo
Study Abstract
A double-blind trial was conducted comparing gemfibrozil with placebo in 2531 men with coronary heart disease an HDL cholesterol level of 40 mgdL or less and an LDL cholesterol level of 140 mgdL or less
The median follow-up was 51 years At one year the mean HDL was 6 higher the mean triglyceride were 31 lower and the mean total cholesterol was 4 lower in the gemfibrozil group than in the placebo group LDL levels did not differ between the groups
A primary event MI or death occurred in 275 of the 1267 placebo patients 217 and in 219 of the 1264 gemfibrozil patients 173 The overall reduction in the risk of an event was 44 percentage points and the reduction in relative risk was 22 95 confidence interval 7 to 35 p0006 A 24 relative risk reduction occurred in the combined outcome of death from coronary heart disease nonfatal myocardial infarction and stroke p0001 Gemfibrozil therapy resulted in a significant reduction in the risk of major cardiovascular events in patients with coronary disease whose primary lipid abnormality was a low HDL cholesterol level The findings suggest that the rate of coronary events is reduced by raising HDL cholesterol levels and lowering levels of triglycerides without lowering LDL cholesterol levels
The major findings were published in the New England Journal of Medicine in August 1999 A paper on lipid screening was published in the Journal of Clinical Epidemiology in July 1999 and one on clinical implications was published in the European Heart Journal Our cost analysis shows that gemfibrozil therapy is highly cost-effective if not cost-saving thus providing a strong rationale for incorporating results into clinical practice A manuscript about lipids as predictors of endpoints was published in JAMA in March 2001 Another paper on stroke was published in Circulation in June 2001 Dr Robins presented data on diabetics in November 2000 at the AHA A paper on cost-effectiveness was published in the Archives of Internal Medicine in January 2002 A manuscript on diabetes has been accepted by the Archives of Internal Medicine
A NHLBI grant for continuing analysis has been funded for two years Other papers in progress include homocysteines in diabetics fasting plasma insulin as a predictor of outcome and the effect of lipoprotein subclass particle size on coronary events
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None