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Effect of pravastatin on cardiovascular events and mortality in 1516 women with coronary heart disease: results from the Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) study.
Am Heart J. 2003 Apr; 145(4):643-51.AH

Abstract

BACKGROUND

The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study showed that cholesterol-lowering therapy prevented further events in patients with coronary heart disease and average cholesterol levels. The aim of this subgroup analysis was to assess the effects of pravastatin in women.

METHODS

A total of 1516 women (756 assigned to take pravastatin) in a cohort of 9014 patients with previous myocardial infarction or unstable angina and a baseline plasma cholesterol level of 4.0 to 7.0 mmol/L (155-271 mg/dL) were assigned to receive pravastatin (40 mg/d) or placebo. Major cardiovascular disease events in 6 years were measured.

RESULTS

Women were at a lesser risk than men for death from any cause (10.3% vs 14.8%, P <.01), death from coronary heart disease (6.6% vs 8.6%, P =.04), and coronary revascularization (13.6% vs 16.2%, P =.05) and at a similar risk of myocardial infarction (9.2% vs 10.5%, P =.26), stroke (3.6% vs 4.7%, P =.11), and hospitalization for unstable angina (25.1% vs 24.5%, P = 0.90). Pravastatin significantly reduced the risk of all prespecified cardiovascular events in all LIPID patients. Relative treatment effects in women did not differ significantly from those in men (P >.05) for any events except hospitalization for unstable angina. There were too few events to demonstrate separately significant effects in women; the estimated relative risk reduction with pravastatin was 11% (95% CI -18%-33%) for coronary heart disease death or nonfatal myocardial infarction, 18% (95% CI -25%-46%) for coronary heart disease death, 16% (95% CI -19%-41%) for myocardial infarction, and 17% (95% CI -2%-33%) for coronary heart disease death, myocardial infarction, or coronary revascularization.

CONCLUSIONS

The study had the largest secondary-prevention female cohort studied thus far, but was not adequately powered to show separate effects in women. Nevertheless, the results were consistent with the main results of this and other trials in showing reduced risks with cholesterol-lowering treatment.

Authors+Show Affiliations

NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia. wendy@ctc.usyd.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12679760

Citation

Hague, Wendy, et al. "Effect of Pravastatin On Cardiovascular Events and Mortality in 1516 Women With Coronary Heart Disease: Results From the Long-Term Intervention With Pravastatin in Ischemic Disease (LIPID) Study." American Heart Journal, vol. 145, no. 4, 2003, pp. 643-51.
Hague W, Forder P, Simes J, et al. Effect of pravastatin on cardiovascular events and mortality in 1516 women with coronary heart disease: results from the Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) study. Am Heart J. 2003;145(4):643-51.
Hague, W., Forder, P., Simes, J., Hunt, D., & Tonkin, A. (2003). Effect of pravastatin on cardiovascular events and mortality in 1516 women with coronary heart disease: results from the Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) study. American Heart Journal, 145(4), 643-51.
Hague W, et al. Effect of Pravastatin On Cardiovascular Events and Mortality in 1516 Women With Coronary Heart Disease: Results From the Long-Term Intervention With Pravastatin in Ischemic Disease (LIPID) Study. Am Heart J. 2003;145(4):643-51. PubMed PMID: 12679760.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of pravastatin on cardiovascular events and mortality in 1516 women with coronary heart disease: results from the Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) study. AU - Hague,Wendy, AU - Forder,Peta, AU - Simes,John, AU - Hunt,David, AU - Tonkin,Andrew, AU - ,, PY - 2003/4/8/pubmed PY - 2003/5/2/medline PY - 2003/4/8/entrez SP - 643 EP - 51 JF - American heart journal JO - Am Heart J VL - 145 IS - 4 N2 - BACKGROUND: The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) study showed that cholesterol-lowering therapy prevented further events in patients with coronary heart disease and average cholesterol levels. The aim of this subgroup analysis was to assess the effects of pravastatin in women. METHODS: A total of 1516 women (756 assigned to take pravastatin) in a cohort of 9014 patients with previous myocardial infarction or unstable angina and a baseline plasma cholesterol level of 4.0 to 7.0 mmol/L (155-271 mg/dL) were assigned to receive pravastatin (40 mg/d) or placebo. Major cardiovascular disease events in 6 years were measured. RESULTS: Women were at a lesser risk than men for death from any cause (10.3% vs 14.8%, P <.01), death from coronary heart disease (6.6% vs 8.6%, P =.04), and coronary revascularization (13.6% vs 16.2%, P =.05) and at a similar risk of myocardial infarction (9.2% vs 10.5%, P =.26), stroke (3.6% vs 4.7%, P =.11), and hospitalization for unstable angina (25.1% vs 24.5%, P = 0.90). Pravastatin significantly reduced the risk of all prespecified cardiovascular events in all LIPID patients. Relative treatment effects in women did not differ significantly from those in men (P >.05) for any events except hospitalization for unstable angina. There were too few events to demonstrate separately significant effects in women; the estimated relative risk reduction with pravastatin was 11% (95% CI -18%-33%) for coronary heart disease death or nonfatal myocardial infarction, 18% (95% CI -25%-46%) for coronary heart disease death, 16% (95% CI -19%-41%) for myocardial infarction, and 17% (95% CI -2%-33%) for coronary heart disease death, myocardial infarction, or coronary revascularization. CONCLUSIONS: The study had the largest secondary-prevention female cohort studied thus far, but was not adequately powered to show separate effects in women. Nevertheless, the results were consistent with the main results of this and other trials in showing reduced risks with cholesterol-lowering treatment. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/12679760/Effect_of_pravastatin_on_cardiovascular_events_and_mortality_in_1516_women_with_coronary_heart_disease:_results_from_the_Long_Term_Intervention_with_Pravastatin_in_Ischemic_Disease__LIPID__study_ DB - PRIME DP - Unbound Medicine ER -