PMID- 22991979
OWN - NLM
STAT- MEDLINE
DCOM- 20130403
LR  - 20211203
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 28
IP  - 10
DP  - 2012 Oct
TI  - Changes in calculated coronary heart disease risk using proactive multifactorial 
      intervention versus continued usual care in Latin-American and non-Latin-American 
      patients enrolled in the CRUCIAL trial.
PG  - 1667-76
LID - 10.1185/03007995.2012.725391 [doi]
AB  - OBJECTIVE: To compare the change in calculated coronary heart disease (CHD) risk 
      using a proactive multifactorial intervention (PMI) versus usual care (UC), among 
      Latin-American (LA) and non-LA patients enrolled in the CRUCIAL trial. RESEARCH 
      DESIGN AND METHODS: This is a sub-analysis of the Cluster Randomized Usual Care 
      versus Caduet Investigation Assessing Long-term-risk (CRUCIAL) trial. CRUCIAL was 
      a prospective, multinational, open-label, cluster-randomized trial. Eligible 
      patients had hypertension and >/=3 additional cardiovascular risk factors, but no 
      history of CHD and baseline total cholesterol </=6.5 mmol/l (250 mg/dl). The PMI 
      strategy was implemented by the inclusion of single-pill amlodipine/atorvastatin 
      (SPAA) in the patients' treatment regimen. Overall, 20% of patients resided in 
      the LA region. MAIN OUTCOME MEASURE: Treatment-related change in calculated 
      Framingham 10-year CHD risk between baseline and Week 52 in the LA and non-LA 
      regions. RESULTS: A greater relative reduction in calculated CHD risk after 52 
      weeks' follow-up was observed for patients in the PMI arm compared with UC arm in 
      both LA (-32.8% vs. -7.5%, p = 0.003) and non-LA regions (-33.1% vs. -3.3%, 
      p < 0.001), region interaction p = 0.316. The proportion of patients 
      discontinuing treatment in the PMI arm due to adverse events (AEs) was low in 
      both regions (both 5.9%). CONCLUSIONS: The PMI approach based on the inclusion of 
      SPAA in the patients' treatment regimen may improve the management of CHD risk 
      among patients residing in LA and non-LA regions. Clinicians may be reassured by 
      the low rate of AEs leading to discontinuation of SPAA in both regions.
FAU - Pavia, Abel
AU  - Pavia A
AD  - Hospital General de Mexico, Ciudad de Mexico, Mexico. vanina@prodigy.net.mx
FAU - Zamorano, Jose
AU  - Zamorano J
FAU - Sutradhar, Santosh
AU  - Sutradhar S
FAU - Yunis, Carla
AU  - Yunis C
CN  - CRUCIAL Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20120919
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Anticholesteremic Agents)
RN  - 0 (Drug Combinations)
RN  - 0 (Heptanoic Acids)
RN  - 0 (Pyrroles)
RN  - 0 (amlodipine, atorvastatin drug combination)
RN  - 1J444QC288 (Amlodipine)
RN  - 97C5T2UQ7J (Cholesterol)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Amlodipine/*administration & dosage/adverse effects
MH  - Anticholesteremic Agents/*administration & dosage/adverse effects
MH  - Cholesterol/blood
MH  - Coronary Disease/blood/epidemiology/ethnology/*therapy
MH  - Drug Combinations
MH  - Female
MH  - Follow-Up Studies
MH  - Heptanoic Acids/*administration & dosage/adverse effects
MH  - *Hispanic or Latino
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention
MH  - Pyrroles/*administration & dosage/adverse effects
MH  - Risk Factors
EDAT- 2012/09/21 06:00
MHDA- 2013/04/04 06:00
CRDT- 2012/09/21 06:00
PHST- 2012/09/21 06:00 [entrez]
PHST- 2012/09/21 06:00 [pubmed]
PHST- 2013/04/04 06:00 [medline]
AID - 10.1185/03007995.2012.725391 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2012 Oct;28(10):1667-76. doi: 10.1185/03007995.2012.725391. 
      Epub 2012 Sep 19.