26th December 2003
The following quote is from:
Lipids Online: Educational Resources in Atherosclerosis
Several large-scale, controlled, randomized clinical trials have provided evidence that statins are effective in reducing CHD events in both primary- and secondary-prevention populations. Their efficacy in CHD risk reduction is truly impressive. Nonfatal myocardial infarction and CHD death were reduced by about 25-40% after just 5 years of treatment; ischemic events requiring hospitalization were reduced by 26-36% after just 18 months of statin therapy. All the statins studied demonstrated the ability to reduce CHD risk—lovastatin in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS), simvastatin in the Scandinavian Simvastatin Survival Study (4S), and pravastatin in the Cholesterol and Recurrent Events (CARE) trial, Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) trial, and West of Scotland Coronary Prevention Study (WOSCOPS). Neither the Atorvastatin versus Revascularization Treatment (AVERT) nor Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial showed significant reductions in hard CHD endpoints; both were short-term trials and not powered to show such a difference. A trend toward benefit on CHD events was shown in the Lipoprotein and Coronary Atherosclerosis Study (LCAS), but this angiographic trial was not powered for clinical events; the effect of fluvastatin on CHD events is being studied in the ongoing Lescol Intervention Prevention Study (LIPS) and Assessment of Lescol in Renal Transplantation (ALERT). The available data suggest that CHD risk reduction by statins is a class effect and that the LDL-C reduction is the key event driving the change in risk.
What makes these studies and their results impressive is that they are "end point" studies. That is to say, they base the results on endpoints, such as heart attack or death, not simply a hypothesis about the potentials based on assumed relationships.
There is no panacea, and there are money interests, to say the least. However, these studies cover several different statins on thousands and thousands of patients with many hundreds of academic researchers involved. The data are impressive.
Lipids Online: Educational Resources in Atherosclerosis
Several large-scale, controlled, randomized clinical trials have provided evidence that statins are effective in reducing CHD events in both primary- and secondary-prevention populations. Their efficacy in CHD risk reduction is truly impressive. Nonfatal myocardial infarction and CHD death were reduced by about 25-40% after just 5 years of treatment; ischemic events requiring hospitalization were reduced by 26-36% after just 18 months of statin therapy. All the statins studied demonstrated the ability to reduce CHD risk—lovastatin in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS), simvastatin in the Scandinavian Simvastatin Survival Study (4S), and pravastatin in the Cholesterol and Recurrent Events (CARE) trial, Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) trial, and West of Scotland Coronary Prevention Study (WOSCOPS). Neither the Atorvastatin versus Revascularization Treatment (AVERT) nor Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial showed significant reductions in hard CHD endpoints; both were short-term trials and not powered to show such a difference. A trend toward benefit on CHD events was shown in the Lipoprotein and Coronary Atherosclerosis Study (LCAS), but this angiographic trial was not powered for clinical events; the effect of fluvastatin on CHD events is being studied in the ongoing Lescol Intervention Prevention Study (LIPS) and Assessment of Lescol in Renal Transplantation (ALERT). The available data suggest that CHD risk reduction by statins is a class effect and that the LDL-C reduction is the key event driving the change in risk.
What makes these studies and their results impressive is that they are "end point" studies. That is to say, they base the results on endpoints, such as heart attack or death, not simply a hypothesis about the potentials based on assumed relationships.
There is no panacea, and there are money interests, to say the least. However, these studies cover several different statins on thousands and thousands of patients with many hundreds of academic researchers involved. The data are impressive.
