This Article Full Text Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Willerson, J. T. Search for Related Content PubMed PubMed Citation Articles by Willerson, J. T.

(Circulation. 1996;94:3054.)
© 1996 American Heart Association, Inc.

Articles

Effect of Pravastatin on Coronary Events After Myocardial Infarction in Patients With Average Cholesterol Levels

James T. Willerson, MD

Correspondence to James T. Willerson, MD, St Luke's Episcopal Hospital/TH1, 6720 Bertner Ave, B524 (MC1-267), Houston, TX 77030-2697.

	Introduction

 
In a recent article in The New England Journal of Medicine,¹ Sacks and his colleagues for the Cholesterol and Recurrent Events Trial Investigators (CARE study) determined whether lowering serum cholesterol values has a benefit on survival and morbidity in patients with coronary heart disease and "average" serum cholesterol levels. In a double-blind trial that lasted 5 years, they administered either 40 mg of pravastatin per day or placebo to 4159 patients (3583 men and 576 women) with myocardial infarction who had plasma total cholesterol levels <240 mg/dL (mean, 209 mg/dL) and LDL cholesterol values of 115 to 174 mg/dL (mean, 139 mg/dL). The primary end point in this study was a fatal coronary event or a nonfatal myocardial infarction.

The primary end point occurred in 10% of the pravastatin-treated patients and 13% of those treated with placebo, an absolute difference of 3 percentage points and a 24% reduction in risk (P=.003). Coronary bypass surgery was required in 7.5% of patients treated with pravastatin and 10% of those in the placebo group, a 26% reduction (P=.005). Coronary angioplasty was required in 8% of the pravastatin group and 11% of the placebo group (P=.01). The frequency of cerebrovascular accidents was reduced by 31% by pravastatin therapy (P=.03). There were no significant differences in overall mortality or mortality from noncardiovascular causes. Pravastatin lowered the rate of coronary events more among women than among men. The reduction in coronary events was also greater in patients . . . [Full Text of this Article]