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Title
Effect of pravastatin on cardiovascular events in older
patients with myocardial infarction and cholesterol
levels in the average range.
Purpose
To determine whether lipid lowering with pravastatin
decreases recurrent cardiovascular events in patients
65 years and older.
Design
As per CARE
Patients
Subset of patients from the CARE Trial who were 65-75
years old. 1283 post MI patients. Total cholesterol
level had to be < 240 mg/dL and LDL cholesterol of
115-174 mg/dL.
Follow-up
5 years
Treatment regimen
As per CARE
Results
• At 5 years major coronary events (coronary death,
nonfatal MI, PTCA or CABG) were reduced in the pravastatin
group
from 28.1% in placebo patients to 19.7% in pravastatin
patients (relative risk reduction = 32%; p < 0.001).
• Death from coronary artery disease was reduced
from 10.3% in placebo patients to 5.8% in the pravastatin
group (relative
risk reduction = 45%; p = 0.004).
• Stroke was reduced from 7.3% in placebo patients
to 4.5% in the pravastatin group (relative risk reduction
= 40%;
p=0.03).
Conclusion
In older post myocardial infarction patients with average
cholesterol levels, pravastatin decreased the rate of
major coronary heart disease events and stroke.
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