Effects of lovastatin and warfarin on early carotid atherosclerosis: sex-specific analysis

Purpose

To evaluate the effects of lovastatin and warfarin on early carotid atherosclerosis

Design

Randomized, placebo-controlled study

Patients

919 patients asymptomatic for cardiovascular disease, with evidence of early carotid atherosclerosis and moderately elevated LDL cholesterol level.

Follow-up

3 years
Primary outcome was 3-year change in the mean maximum intimal-medial thickness of the carotid arteries as measured by B-mode ultrasonography.

Treatment regimen

Lovastatin vs. warfarin vs. lovastatin-warfarin combination vs placebo

Results

• Both men and women experienced reduction in disease progression with lovastatin
• Women experienced disease regression to the greatest extent with lovastatin + warfarin combination, although women
on lovastatin alone also had a reduction in progression
• Men experienced the greatest reduction with lovastatin alone, although warfarin may also reduce progression to some
extent

Conclusion

Lovastatin is beneficial in reducing disease progression in women and men. Warfarin has no effect in women, although it may reduce progression in men. In men, warfarin does not add to the benefit of lovastatin and has no advantage over lovastatin alone.