SEARCH Study
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Objective
To study the efficacy and safety of prolonged use of more intensive cholesterol-lowering therapy in patients at high cardiovascular risk.
Methods
Study of the effectiveness of additional reductions in cholesterol and homocysteine (SEARCH) was a randomized, double blinded study which enrolled 12,064 men and women aged 18-80 years with a history of myocardial infarction. In addition these patients were randomly assigned to homocysteine lowering with folic acid 2 mg plus vitamin B12 1 mg daily versus matching placebo. The primary endpoint was major vascular events, defined as coronary death, myocardial infarction, stroke, or arterial revascularization.
Results
- Major vascular events occurred in 24.5% of patients receiving 80 mg simvastatin versus 25.7% of those receiving 20 mg.
- An average of 0.35 mmol/L greater reduction in LDL-C was observed in the group receiving 80 mg simvastatin compared to those receiving 20 mg.
- Overall 6% reduction in major vascular events was observed in the 80 mg group compared with the 20 mg group.
- Myopathy occurred in 0.9% patients taking 80 mg simvastatin compared with 0.03% patients in the 20 mg simvastatin group.
Conclusion
The SEARCH study failed to find a benefit with more intensive therapy as a significant number of patients in the 20 mg simvastatin group took an additional statin off protocol as more intensive LDL-C goals were promulgated.[1][2]
References
- ↑ Armitage J, Bowman L, Wallendszus K; et al. (2010). "Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12,064 survivors of myocardial infarction: a double-blind randomised trial". Lancet. 376 (9753): 1658–69. doi:10.1016/S0140-6736(10)60310-8. PMC 2988223. PMID 21067805. Unknown parameter
|month=ignored (help) - ↑ Bowman L, Armitage J, Bulbulia R, Parish S, Collins R (2007). "Study of the effectiveness of additional reductions in cholesterol and homocysteine (SEARCH): characteristics of a randomized trial among 12064 myocardial infarction survivors". American Heart Journal. 154 (5): 815–23, 823.e1–6. doi:10.1016/j.ahj.2007.06.034. PMID 17967584. Unknown parameter
|month=ignored (help)