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Odkazy a zdroje - Studie - LIPID



LIPID

Long-term Intervention with Pravastatin in Ischemic Disease

Author(s)
(a) LIPID study group
(b) Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group

Title(s)
(a) Design features and baseline characteristics of the LIPID (Long-term Intervention with Pravastatin in Ischemic Disease) study: a randomized trial in patients with previous acute myocardial infarction and/or unstable angina pectoris
(b) Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels

Reference(s)
(a) Am J Cardiol 1995;76:474-9
(b) N Engl J Med 1998;339:1349-57

Disease
AMI and/or unstable angina pectoris

Purpose
To determine whether treatment with pravastatin will reduce coronary mortality and morbidity in patients with a history of AMI or unstable angina pectoris and a baseline cholesterol of 4.0-7.0 mmol/l

Study design
Randomised, double-blind, placebo-controlled

Follow-up
Mean 6.1 years

Patients
9014 patients (4512 pravastatin, 4502 placebo), aged 31-75 years, with AMI (5754 patients) or previous hospitalisation for unstable angina pectoris (3260 patients) 3-36 months previously

Treatment regimen
Pravastatin, 40 mg once daily, or placebo

Concomitant therapy
Dietary counselling

Results
Death from coronary heart disease (6.4% vs 8.3%, relative risk reduction, RRR, 24%; p < 0.001) and overall mortality (11.0% vs 14.1%, RRR 22%; p < 0.001) were significantly lower in the pravastatin group than in the placebo group. Pravastatin-treated patients showed a consistently lower incidence of cardiovascular outcomes, including MI (RRR 29%; p < 0.001), death from coronary heart disease or nonfatal MI (RRR 24%; p < 0.001), stroke (RRR 19%; p = 0.048) and coronary revascularisation (RRR 20%; p < 0.001)

Comments
The study incorporates several substudies, eg on cost-effectiveness, quality of life, diet, and carotid ultrasound. The longer-term effects of initial treatment with pravastatin on further cardiovascular events and mortality over a total follow-up of 8 years have been reported in Lancet 2002;359:1379–87