Cardiovascular outcome trial · JAMA 1984
LRC-CPPT trial
The Lipid Research Clinics Coronary Primary Prevention Trial results. I. Reduction in incidence of coronary heart disease.
The bottom line
Lowering LDL-C with cholestyramine significantly reduced coronary heart disease events in high-risk hypercholesterolemic men, though it did not significantly reduce overall mortality.
BenefitUS status: US-approved
At a glance
- Medicine
- cholestyramine resin (bile acid sequestrant)
- Compared with
- placebo
- People
- 3,806
- Who took part
- 3,806 asymptomatic middle-aged men with primary hypercholesterolemia (type II hyperlipoproteinemia)
- Design
- multicenter, randomized, double-blind study
- Follow-up
- average of 7.4 years
- Main question
- definite CHD death and/or definite nonfatal myocardial infarction
Main result
The cholestyramine group experienced a 19% reduction in risk (p less than .05) of the primary end point; cumulative seven-year incidence was 7% in the cholestyramine group v 8.6% in the placebo group.
Effect on LDL cholesterol
average plasma total and low-density lipoprotein cholesterol (LDL-C) reductions of 13.4% and 20.3%, respectively, which were 8.5% and 12.6% greater reductions than those obtained in the placebo group
Other results
24% reduction in definite CHD death and a 19% reduction in nonfatal myocardial infarction; incidence rates for new positive exercise tests, angina, and coronary bypass surgery were reduced by 25%, 20%, and 21%, respectively; risk of death from all causes was only slightly and not significantly reduced (7% decrease)
Safety
The risk of death from all causes was only slightly and not significantly reduced in the cholestyramine group. The magnitude of this decrease (7%) was less than for CHD end points because of a greater number of violent and accidental deaths in the cholestyramine group.
In the trial's own words
“The cholestyramine group experienced a 19% reduction in risk (p less than .05) of the primary end point--definite CHD death and/or definite nonfatal myocardial infarction--reflecting a 24% reduction in definite CHD death and a 19% reduction in nonfatal myocardial infarction.”
Quoted from the abstract of JAMA 1984, checked word for word against PubMed. PubMed 6361299 · Full paper (DOI)
How this medicine works, where it stands and what it costs: Bile acid sequestrants (colesevelam)
Common questions
What did the LRC-CPPT trial find?
Lowering LDL-C with cholestyramine significantly reduced coronary heart disease events in high-risk hypercholesterolemic men, though it did not significantly reduce overall mortality.
Who was in LRC-CPPT?
3,806 people. 3,806 asymptomatic middle-aged men with primary hypercholesterolemia (type II hyperlipoproteinemia).
What was LRC-CPPT's main result?
The cholestyramine group experienced a 19% reduction in risk (p less than .05) of the primary end point; cumulative seven-year incidence was 7% in the cholestyramine group v 8.6% in the placebo group.
How much did LDL cholesterol change in LRC-CPPT?
average plasma total and low-density lipoprotein cholesterol (LDL-C) reductions of 13.4% and 20.3%, respectively, which were 8.5% and 12.6% greater reductions than those obtained in the placebo group
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