EFFECT OF PRAVASTATIN ON CARDIOVASCULAR EVENTS IN WOMEN AFTER MYOCARDIAL-INFARCTION - THE CHOLESTEROL AND RECURRENT EVENTS (CARE) TRIAL

Citation
Sj. Lewis et al., EFFECT OF PRAVASTATIN ON CARDIOVASCULAR EVENTS IN WOMEN AFTER MYOCARDIAL-INFARCTION - THE CHOLESTEROL AND RECURRENT EVENTS (CARE) TRIAL, Journal of the American College of Cardiology, 32(1), 1998, pp. 140-146
Citations number
37
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
0735-1097
Volume
32
Issue
1
Year of publication
1998
Pages
140 - 146
Database
ISI
SICI code
0735-1097(1998)32:1<140:EOPOCE>2.0.ZU;2-#
Abstract
Objectives. We sought to determine the effect of pravastatin on recurr ent cardiovascular events in women with average cholesterol levels aft er myocardial infarction (MI). Background. Little information is avail able on the effectiveness of lipid lowering in secondary prevention of coronary heart disease (CHD) in women; in particular, those with CHD and average cholesterol levels. Methods. In the Cholesterol and Recurr ent Events (CARE) trial, 576 postmenopausal women, between 3 and 20 mo nths after MI, with a total cholesterol level <240 mg/dl and a low den sity lipoprotein cholesterol level 115 to 174 mg/dl, mere randomized t o receive pravastatin 40 mg/day or matching placebo for a median follo w-up period of 5 years. The main outcome measures were combined corona ry events (coronary death, nonfatal MI, percutaneous transluminal coro nary angioplasty [PTCA] or coronary artery bypass graft surgery [CABG] ), the primary trial end point (coronary death or nonfatal MI) and str oke. Results. Women treated with pravastatin had a risk reduction of 4 3% for the primary end point (p = 0.035), 46% for combined coronary ev ents (p = 0.001), 48% for PTCA (p = 0.025), 40% for CABG (p = 0.14) an d 56% for stroke (p = 0.07). The 3,583 men in the CARE trial also show ed a reduction in risk, but the magnitude tended to be less. Pravastat in improved plasma lipids similarly in men and women. There were no di fferences in risk of coronary events in the placebo group between men and women. Minor differences between men and women were present in bas eline characteristics and treatment for MI, in general, conferring a h igher risk status and a lower incidence of CABG in the women. Conclusi ons. Pravastatin led to significant early reduction of a wide range of cardiovascular events in post-MI women with average cholesterol level s. (C) 1998 by the American College of Cardiology.