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Pravastatin Mortality Benefit In Patients With And Without Heart Disease

Patients with coronary heart disease and those without but who have raised cholesterol show a reduction in all-cause mortality and coronary mortality when treated for five years with pravastatin.

This was the conclusion from pooling data from three large long-term prevention studies: the Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study; the Cholesterol and Recurrent Event (CARE) study; and the West Scotland Coronary Prevention Study.

The meta-analysis involved 13,173 patients with coronary heart disease and 6595 men with no coronary heart disease but with elevated cholesterol at the start of the study. The patients received either 40 mg daily pravastatin or placebo.

According to Dr J Simes, lead author, "For all three trials combined, the mortality among patients assigned pravastatin was significantly lower, at 7.9 percent, than the 9.8 percent among those assigned placebo." This was a highly significant relative risk reduction of 20 percent (95 percent confidence interval 12-27 percent; P<0.001). Similarly, the patients actively treated with pravastatin showed a reduction in coronary mortality of 24 percent compared with the placebo group (95 percent confidence interval 14-33 percent).

The size of the benefit seen in patients was related to their risk at the study start, with the patients with heart disease at the study start having the largest benefit in terms of reduced mortality.
European Heart Journal 2002;23(3): 207-215. "Effects of pravastatin on mortality in patients with and without coronary heart disease across a broad range of cholesterol levels. The Prospective Pravastatin Pooling project"

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