Long-term effectiveness and safety of pravastatin in 9014 patients with coronary heart disease and average cholesterol concentrations: the LIPID trial follow-up
Abstract
Background The Long-term Intervention with Pravastatin in Ischaemic Disease (LIPID) study showed that pravastatin therapy over 6 years reduced mortality and cardiovascular events in patients with previous acute coronary syndromes and average cholesterol concentrations. We assessed the longer-term effects of initial treatment with pravastatin on further cardiovascular events and mortality over a total follow-up period of 8 years. Methods In the main trial, 9014 patients with previous myocardial infarction or unstable angina and a baseline plasma cholesterol concentration of 4.0-7.0 mmol/L were randomly assigned pravastatin 40 mg daily or placebo and followed up for 6 years. Subsequently, all patients were offered open-label pravastatin for 2 more years. Major cardiovascular events and adverse events were compared according to initial treatment assignment. Findings 7680 (97% of those still alive) had 2 years of extended follow-up. 3766 (86%) of those assigned placebo and 3914 (88%) assigned pravastatin agreed to take open-label pravastatin. During this period, patients originally assigned pravastatin had almost identical cholesterol concentrations to those assigned placebo, but a lower risk of death from all causes (219 [5.6%] vs 255 [6.8%], p=0.029), coronary heart disease (CHD) death (108 [2.8%] vs 137 [3.6%], p=0.026), and CHD death or non-fatal myocardial infarction (176 [4.5%] vs 196 [5.2%], p=0.08). Over the total 8-year period, all-cause mortality was 888 (19.7%) in the…
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After an average follow-up of 17 years in the DCCT follow-up trial, the original intensive-therapy treatment was associated with an absolute risk reduction of 2.8% for a composite cardiovascular end point.
“After an average follow-up of 17 years, the original intensive-therapy treatment was associated with an absolute risk reduction of 2.8% for a composite cardiovascular end point.”
From Effect of a multifactorial intervention on mortality in type 2 diabetes (2008) · cites this paper as [25]
In the DCCT follow-up trial, glucose regulation deteriorated in the original intensive-therapy group and improved in the control group, resulting in a convergence of the glycemic levels in the two groups.
“In the DCCT follow-up trial, glucose regulation deteriorated in the original intensive-therapy group and improved in the control group, resulting in a convergence of the glycemic levels in the two groups.”
From Effect of a multifactorial intervention on mortality in type 2 diabetes (2008) · cites this paper as [25]
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References 32 · Cited by 271
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2002-04
- Volume
- 359
- Issue
- 9315
- Pages
- 1379-1387
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W1597507340
- Cited by
- 271
- References
- 32
- Citations by year
- 2026: 7 · 2025: 3 · 2024: 10 · 2023: 12 · 2022: 8 · 2021: 8 · 2020: 7 · 2019: 4 · 2018: 4 · 2017: 6 · 2016: 14 · 2015: 11 · 2014: 17 · 2013: 13 · 2012: 12
- FWCI
- 18.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bristol-Myers Squibb
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- pravastatin, coronary artery disease, long-term statin therapy, LIPID trial, all-cause mortality, cardiovascular events, myocardial infarction, stroke, coronary heart disease mortality, hypercholesterolemia, secondary prevention, open-label extension, adverse drug reactions, drug safety, lipid-lowering therapy, acute coronary syndrome
- MeSH terms
- Adult, Aged, Angina, Unstable, Anticholesteremic Agents, Cholesterol, Coronary Disease, Double-Blind Method, Female, Follow-Up Studies, Humans, Cholesterol, LDL, Male, Middle Aged, Myocardial Infarction, Risk, Time Factors, Survival Analysis, Treatment Outcome, Pravastatin, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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