Cited by 416Lipoproteins and Cardiovascular HealthAcute Myocardial Infarction ResearchCancer, Lipids, and Metabolism

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Long-Term Follow-up of the West of Scotland Coronary Prevention Study

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Ford, Ian, Murray, Heather, Packard, Chris J., Shepherd, James, Macfarlane, Peter W., Cobbe, Stuart M.·2007·New England Journal of Medicine

DOI 10.1056/nejmoa065994

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Abstract

BACKGROUND: The West of Scotland Coronary Prevention Study was a randomized clinical trial comparing pravastatin with placebo in men with hypercholesterolemia who did not have a history of myocardial infarction, with an average follow-up of approximately 5 years. The combined outcome of death from definite coronary heart disease or definite nonfatal myocardial infarction was reduced from 7.9 to 5.5% (P<0.001) in the treatment group. Extended follow-up data were obtained for approximately 10 years after completion of the trial. METHODS: For the survivors of the trial, all deaths, hospitalizations and deaths due to coronary events and stroke, and incident cancers and deaths from cancer were tracked with the use of a national computerized record-linkage system. The results were analyzed with time-to-event analyses and use of Cox proportional-hazards models. RESULTS: Five years after the trial ended, 38.7% of the original statin group and 35.2% of the original placebo group were being treated with a statin. In the period approximately 10 years after completion of the trial, the risk of death from coronary heart disease or nonfatal myocardial infarction was 10.3% in the placebo group and 8.6% in the pravastatin group (P=0.02); over the entire follow-up period, the rate was 15.5% in the placebo group and 11.8% in the pravastatin group (P<0.001). Similar percentage reductions were seen in the combined rate of death from coronary heart disease and hospitalization for coronary events for both periods. The rate of death from cardiovascular causes was reduced (P=0.01), as was the rate of death from any cause (P=0.03), over the entire follow-up period. There were no excess deaths from noncardiovascular causes or excess fatal or incident cancers. CONCLUSIONS: 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.

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“In conclusion, our study and other epidemiologic studies indicate that statins are safe in relation to prostate cancer risk but any chemopreventive effect remains to be established and recent report of increased prostate cancer risk with pravastatin use from the long-term follow-up of the West of Scotland Coronary Pre…”
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Authors: Ford, I., Murray, H., Packard, C. J., Shepherd, J., Macfarlane, P. W., & Cobbe, S. M.
Affiliations: University of Glasgow (GB)
ORCID: Ford, Ian
Packard, Chris J.
Macfarlane, Peter W.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2007-10-11
Volume: 357
Issue: 15
Pages: 1477-1486
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa065994
OpenAlex: W1973491874
Cited by: 416
References: 23
Citations by year: 2026: 4 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 9 · 2021: 9 · 2020: 7 · 2019: 14 · 2018: 23 · 2017: 26 · 2016: 29 · 2015: 19 · 2014: 34 · 2013: 46 · 2012: 28
FWCI: 36.61
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › 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, statins, hypercholesterolemia, coronary artery disease, myocardial infarction, long-term follow-up, secondary prevention, cardiovascular mortality, cancer incidence, men
MeSH terms: Anticholesteremic Agents, Coronary Disease, Follow-Up Studies, Humans, Hypercholesterolemia, Male, Middle Aged, Myocardial Infarction, Pravastatin, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Kaplan-Meier Estimate

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Long-Term Follow-up of the West of Scotland Coronary Prevention Study

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