Research question What are the effects of statin therapy on total, vascular, and nonvascular mortality in people at high risk of coronary artery disease (CAD)? Does dietary supplementation with antioxidant vitamins have any effect on CAD events? Type of article and design Multicentre, randomized, blinded, placebo-controlled trial using a 2x2 factorial design to allow separate assessment of simvastatin (40 mg) and vitamin supplementation (600 mg of vitamin E, 250 mg of vitamin C, and 20 mg of β-carotene). The factorial design allows all subjects to contribute fully to assessment of the separate effects of simvastatin and antioxidant supplementation without increase in sample size or study cost.
The clinical meaning of high values of blood lipid peroxides, assessed as thiobarbituric acid reactive substances (TBA-RS), was investigated in 19 selected high risk patients with transient ischemic attacks (TIA). Patients were checked every 3-6 months and followed-up for 3 years. 8 patients experienced further vascular episodes, 4 having minor stroke and 4 TIA; one of the latter died from myocardial infarction. Unlike blood cholesterol and glucose. TBA-RS values discriminated patients with vascular episodes: they, indeed, showed significant higher values of TBA-RS. Discriminant analysis further indicated that TBA-RS levels differentiate patients with and without vascular accidents, suggesting that high blood values of lipid peroxides could represent a predictive sign of vascular ischemia.
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