Wendy E Hague1, John Simes2, Adrienne Kirby2, Anthony C Keech2, Harvey D White2, David Hunt2, Paul J Nestel2, David M Colquhoun2, Helen Pater2, Ralph A Stewart2, David R Sullivan2, Peter L Thompson2, Malcolm West2, Paul P Glasziou2, Andrew M Tonkin2. 1. From National Health and Medical Research Council Clinical Trials Centre, University of Sydney, New South Wales, Australia (W.E.H., J.S., A.K., A.C.K., H.P.); Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand (H.D.W., R.A.S.); Department of Cardiology, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia (D.H.); Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia (P.J.N.); Greenslopes Hospital, Brisbane, Queensland, Australia (D.M.C.); Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (D.R.S.); University of Western Australia, Perth, Australia (P.L.T.); University of Queensland, Brisbane, Queensland, Australia (M.W.); Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia (P.P.G.); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (A.M.T.) wendy@ctc.usyd.edu.au. 2. From National Health and Medical Research Council Clinical Trials Centre, University of Sydney, New South Wales, Australia (W.E.H., J.S., A.K., A.C.K., H.P.); Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand (H.D.W., R.A.S.); Department of Cardiology, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia (D.H.); Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia (P.J.N.); Greenslopes Hospital, Brisbane, Queensland, Australia (D.M.C.); Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (D.R.S.); University of Western Australia, Perth, Australia (P.L.T.); University of Queensland, Brisbane, Queensland, Australia (M.W.); Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia (P.P.G.); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (A.M.T.).
Abstract
BACKGROUND: 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. METHODS AND RESULTS: 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. CONCLUSIONS: 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.
RCT Entities:
BACKGROUND: 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. METHODS AND RESULTS: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. CONCLUSIONS: 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.
Authors: Michael J Seckl; Christian H Ottensmeier; Michael Cullen; Peter Schmid; Yenting Ngai; Dakshinamoorthy Muthukumar; Joyce Thompson; Susan Harden; Gary Middleton; Kate M Fife; Barbara Crosse; Paul Taylor; Stephen Nash; Allan Hackshaw Journal: J Clin Oncol Date: 2017-02-27 Impact factor: 44.544
Authors: Aleksandr B Shek; Ravshanbek D Kurbanov; Guzal J Abdullaeva; Aleksandr V Nagay; Shavkat U Hoshimov; Ulugbek I Nizamov; Adolat V Ziyaeva; Rano B Alieva Journal: Arch Med Sci Atheroscler Dis Date: 2017-10-05