IHD (WOSCOPS)

6595 middle-aged men (age 45-64) with a mean cholesterol of 7.0 +/- 0.6 mmol were randomised to pravastatin 40 mg per day or placebo.

The average follow-up was 4.9 years.

Pravastatin altered serum lipids in the following manner:

• serum cholesterol was reduced by 20%
• serum LDL cholesterol was reduced by 26%

The relative risks in the pravastatin group reduced by:

• 31% for coronary events
• 31% for non-fatal myocardial infarction
• 28% for death from definite coronary artery disease
• reduction in total mortality by 22%

There was no significant excess in non-cardiovascular deaths in the pravastatin group.

Calculated - treating 1000 patients for 5 years - saves 7 deaths from CHD and 20 non-fatal MIs (1)

Primary prevention with pravastatin for 5 years continued to prevent coronary events in the following 10 years (2):

• in this analysis, 5 years of treatment with pravastatin was associated with a significant reduction in coronary events for a subsequent 10 years in men with hypercholesterolemia who did not have a history of myocardial infarction

Reference:

• (1) Shepherd, J. et al. (1995). Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. New Engl J Med. 333, 1301-7.
• (2) Ford I et al. Long-term follow-up of the West of Scotland Coronary Prevention Study.N Engl J Med. 2007 Oct 11;357(15):1477-86.