Long-term effectiveness and safety of pravastatin in patients with coronary heart disease

Hague, Wendy E., Simes, John, Kirby, Adrienne, Keech, Anthony C., White, Harvey D., Hunt, David, Nestel, Paul J., Colquhoun, David M., Pater, Helen, Stewart, Ralph A., Sullivan, David R., Thompson, Peter L., West, Malcolm, Glasziou, Paul P. and Tonkin, Andrew M. (2016) Long-term effectiveness and safety of pravastatin in patients with coronary heart disease. Circulation, 133 19: 1851-1860. doi:10.1161/CIRCULATIONAHA.115.018580


Author Hague, Wendy E.
Simes, John
Kirby, Adrienne
Keech, Anthony C.
White, Harvey D.
Hunt, David
Nestel, Paul J.
Colquhoun, David M.
Pater, Helen
Stewart, Ralph A.
Sullivan, David R.
Thompson, Peter L.
West, Malcolm
Glasziou, Paul P.
Tonkin, Andrew M.
Title Long-term effectiveness and safety of pravastatin in patients with coronary heart disease
Journal name Circulation   Check publisher's open access policy
ISSN 1524-4539
0009-7322
Publication date 2016-05-10
Year available 2016
Sub-type Article (original research)
DOI 10.1161/CIRCULATIONAHA.115.018580
Open Access Status Not yet assessed
Volume 133
Issue 19
Start page 1851
End page 1860
Total pages 10
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2017
Language eng
Formatted abstract
Background: We aimed to assess the long-term effects of treatment with statin therapy on all-cause mortality, cause-specific mortality, and cancer incidence from extended follow-up of the Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) trial.

Methods and Results: LIPID initially compared pravastatin and placebo over 6 years in 9014 patients with previous coronary heart disease. After the double-blind period, all patients were offered open-label statin therapy. Data were obtained over a further 10 years from 7721 patients, by direct contact for 2 years, by questionnaires thereafter, and from mortality and cancer registries. During extended follow-up, 85% assigned pravastatin and 84% assigned placebo took statin therapy. Patients assigned pravastatin maintained a significantly lower risk of death from coronary heart disease (relative risk [RR] 0.89; 95% confidence interval [CI], 0.81-0.97; P=0.009), from cardiovascular disease (RR, 0.88; 95% CI, 0.81-0.95; P=0.002), and from any cause (RR, 0.91; 95% CI, 0.85-0.97; absolute risk reduction, 2.6%; P=0.003).Cancer incidence was similar by original treatment group during the double-blind period (RR, 0.94; 95% CI, 0.82-1.08; P=0.41), later follow-up (RR, 1.02; 95% CI, 0.91-1.14; P=0.74), and overall (RR, 0.99; 95% CI, 0.91-1.08; P=0.83). There were no significant differences in cancer mortality, or in the incidence of organ-specific cancers. Cancer findings were confirmed in a meta-analysis with other large statin trials with extended follow-up.

Conclusions: In LIPID, the absolute survival benefit from 6 years of pravastatin treatment appeared to be maintained for the next 10 years, with a similar risk of death among survivors in both groups after the initial period. Treatment with statins does not influence cancer or death from noncardiovascular causes during long-term follow-up.
Keyword Cardiovascular diseases
Cholesterol
Coronary disease
Hydroxymethylglutaryl-CoA reductase inhibitors
Lipids
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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