Long-term effectiveness and safety of pravastatin in patients with coronary heart disease: Sixteen years of follow-up of the LIPID study

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Journal Article

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NHMRC research grants: 1037786, 1010279, 490968

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Hague, W.E., Simes, J., Kirby, A., Keech, A.C., White, H.D., Hunt, D., Nestel, P.J., Colquhoun, D.M., Pater, H., Stewart, R.A., Sullivan, D.R., Thompson, P.L., West, M., Glasziou P.P., Tonkin, A.M.; LIPID Investigators (2016). Long-term effectiveness and safety of pravastatin in patients with coronary heart disease: Sixteen years of follow-up of the LIPID study. Circulation, 133 (19), 1851-1860.

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© Copyright, American Heart Association, 2016





We aimed to assess the long-term effects of treatment with statin therapy on all-cause mortality, cause-specific mortality, and cancer incidence from extended follow-up of the Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) trial.


LIPID initially compared pravastatin and placebo over 6 years in 9014 patients with previous coronary heart disease. After the double-blind period, all patients were offered open-label statin therapy. Data were obtained over a further 10 years from 7721 patients, by direct contact for 2 years, by questionnaires thereafter, and from mortality and cancer registries. During extended follow-up, 85% assigned pravastatin and 84% assigned placebo took statin therapy. Patients assigned pravastatin maintained a significantly lower risk of death from coronary heart disease (relative risk [RR] 0.89; 95% confidence interval [CI], 0.81-0.97; P=0.009), from cardiovascular disease (RR, 0.88; 95% CI, 0.81-0.95; P=0.002), and from any cause (RR, 0.91; 95% CI, 0.85-0.97; absolute risk reduction, 2.6%; P=0.003).Cancer incidence was similar by original treatment group during the double-blind period (RR, 0.94; 95% CI, 0.82-1.08; P=0.41), later follow-up (RR, 1.02; 95% CI, 0.91-1.14; P=0.74), and overall (RR, 0.99; 95% CI, 0.91-1.08; P=0.83). There were no significant differences in cancer mortality, or in the incidence of organ-specific cancers. Cancer findings were confirmed in a meta-analysis with other large statin trials with extended follow-up.


In LIPID, the absolute survival benefit from 6 years of pravastatin treatment appeared to be maintained for the next 10 years, with a similar risk of death among survivors in both groups after the initial period. Treatment with statins does not influence cancer or death from noncardiovascular causes during long-term follow-up.

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