The PREVEND IT
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The prevend it

The PREVEND IT

Source:

Brouwers FP, Asselbergs FW, Hillege HL, et al. Long-term effects of fosinopril and pravastatin on cardiovascular events in subjects with microalbuminuria: ten years of follow-up of Prevention of Renal and Vascular End-stage Disease Intervention Trial (PREVEND IT). Am Heart J. 2011;161(6):1171–1178.


The prevend it

Background:

This study understands the effect of treatment that is targeted at lowering urinary albumin excretion (UAE). Extended follow-up data of over 10 years has also been accumulated, which helped to investigate the long-term effects of fosinopril and pravastatin on cardiovascular (CV) outcomes.


The prevend it

  • Aim:

    • (i) To investigate whether treatment targeted at lowering UAE would reduce adverse CV events (the PREVEND IT).

  • (ii) To investigate effects of fosinopril 20 mg and pravastatin 40 mg on CV outcomes in subjects with UAE >15 mg per 24 h (follow-up data of approximately 10 years).


The prevend it

Methods:

• Number of patients: 864 participants and 839 survivors after 4 years.

• Primary endpoint of every survivor was determined by the combined incidence of CV mortality and hospitalization for CV morbidity.

• Mean total extended follow-up in the PREVEND IT was 9.5 years (range: 9.4–10.7 years).


The prevend it

Results:

• No reduction in the primary endpoint compared to placebo was observed in fosinopril group after 4 years of treatment (hazard ratio [HR]: 0.87, 95% CI: 0.61–1.24 [p=0.42]).

• Total event rate of 29.5% seen in subjects with a baseline UAE in the upper quintile (>50 mg/24 h) after 9.5 years. They were also at high risk for developing CV diseases (HR: 2.03, 95% CI: 1.38–2.97 [p≤0.01]).

• Risk reduction of 45% observed in fosinopril treatment group compared to placebo (95% CI: 6–75% [p=0.04]).

• No overall risk reduction in primary endpoint observed in subjects who were assigned to pravastatin (p=0.99).


The prevend it

Conclusion:

There exists a positive correlation between elevated UAE and CV mortality and morbidity; the CV risk doubles if the UAE exceeds >50 mg/day.


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