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Letters
February 3, 1999

Coronary Events With Lipid-Lowering Therapy: The AFCAPS/TexCAPS Trial

Author Affiliations
 

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim Co-EditorIndividualAuthor

JAMA. 1999;281(5):414-419. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-5-jbk0203

To the Editor: Dr Downs and colleagues1 state that there were no differences between lovastatin at 20 mg/d and placebo for "clinically important" elevations in transaminases (>3 times the normal upper limit) and creatine kinase (>10 times the normal upper limit). More complete data should be given to allow readers to make their own judgment on the clinical importance of these (possibly other) adverse effects. Second, the dose of lovastatin was titrated to optimize lipid reduction. Half the subjects needed maintenance at 40 mg/d, but they were excluded from analysis of the above adverse effects. Third, 42% of treated subjects reached the study target for low-density lipoprotein cholesterol (LDL-C), but they were not compared with those who did not. This seems a strange oversight in a study designed to determine the benefit of cholesterol reduction.

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