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Long-term effectiveness and safety of pravastatin in patients with coronary heart disease: Sixteen years of follow-up of the LIPID study
Circulation
  • Wendy E Hague, University of Sydney, Australia
  • John Simes, University of Sydney
  • Adrienne Kirby, University of Sydney
  • Anthony C Keech, University of Sydney
  • Harvey D White, Auckland City Hospital
  • David Hunt, University of Melbourne
  • Paul J Nestel, Baker IDI Heart & Diabetes Institute, Melbourne
  • David M Colquhoun, Greenslopes Hospital, Brisbane
  • Helen Pater, University of Sydney
  • Ralph A Stewart, Auckland City Hospital
  • David R Sullivan, Royal Prince Alfred Hospital, Sydney
  • Peter L Thompson, University of Western Australia
  • Malcolm West, University of Queensland, Brisbane
  • Paul P. Glasziou, Bond University
  • Andrew Tonkin, Monash University
Date of this Version
5-10-2016
Document Type
Journal Article
Grant Number
NHMRC research grants: 1037786, 1010279, 490968
Publication Details

Citation only

Hague, W.E., Simes, J., Kirby, A., Keech, A.C., White, H.D., Hunt, D., Nestel, P.J., Colquhoun, D.M., Pater, H., Stewart, R.A., Sullivan, D.R., Thompson, P.L., West, M., Glasziou P.P., Tonkin, A.M.; LIPID Investigators (2016). Long-term effectiveness and safety of pravastatin in patients with coronary heart disease: Sixteen years of follow-up of the LIPID study. Circulation, 133 (19), 1851-1860.

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© Copyright, American Heart Association, 2016

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.

Citation Information
Wendy E Hague, John Simes, Adrienne Kirby, Anthony C Keech, et al.. "Long-term effectiveness and safety of pravastatin in patients with coronary heart disease: Sixteen years of follow-up of the LIPID study" Circulation Vol. 133 Iss. 19 (2016) p. 1851 - 1860 ISSN: 0009-7322
Available at: http://works.bepress.com/paul_glasziou/190/