Evidence that pravastatin is of long-term benefit when started after hospital admission for unstable angina is provided by the results of a new trial.
A substudy from the LIPID (long-term intervention with pravastatin in ischaemic disease) trial showed that pravastatin improved survival to the end of a six-year follow-up period and that relative benefits appeared to increase with time. In the study, patients were assigned to receive 40mg pravastatin or placebo daily, which was started between three and 36 months after diagnosis of unstable angina or acute myocardial infarction.
Pravastatin was equally effective for both conditions. In 3,260 patients with unstable angina, the risk reduction in all-cause mortality with pravastatin was 26.3 per cent. For 5,754 patients with myocardial infarction, this risk reduction was 20.6 per cent.
The researchers, Professor Andrew Tonkin (National Heart Foundation of Australia) and colleagues, comment that the results show the benefits of pravastatin started some time after diagnosis for unstable
They comment: “In absolute terms, pravastatin treatment of 1,000 patients with unstable angina would have prevented 33 deaths, 24 non-fatal myocardial infarctions and 26 episodes of myocardial revascularisation”(Lancet 2000;356:1871).