Cardiovascular outcome trial · N Engl J Med 1998
LIPID trial
Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.
The bottom line
In patients with coronary heart disease and a broad range of cholesterol levels, pravastatin reduced death from coronary heart disease, overall mortality, and other cardiovascular events compared with placebo.
BenefitUS status: US-approved
At a glance
- Medicine
- Pravastatin 40 mg daily
- Compared with
- Placebo
- People
- 9,014
- Who took part
- Patients 31 to 75 years of age with a history of myocardial infarction or hospitalization for unstable angina and initial plasma total cholesterol levels of 155 to 271 mg per deciliter
- Design
- double-blind, randomized trial
- Follow-up
- mean follow-up period of 6.1 years
- Main question
- Mortality from coronary heart disease
Main result
Death from coronary heart disease occurred in 8.3 percent of the patients in the placebo group and 6.4 percent of those in the pravastatin group, a relative reduction in risk of 24 percent (95 percent confidence interval, 12 to 35 percent; P<0.001).
Effect on LDL cholesterol
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Other results
Overall mortality was 14.1 percent in the placebo group and 11.0 percent in the pravastatin group (relative reduction in risk, 22 percent; 95 percent confidence interval, 13 to 31 percent; P<0.001).
Safety
There were no clinically significant adverse effects of treatment with pravastatin.
In the trial's own words
“Death from coronary heart disease occurred in 8.3 percent of the patients in the placebo group and 6.4 percent of those in the pravastatin group, a relative reduction in risk of 24 percent (95 percent confidence interval, 12 to 35 percent; P<0.001).”
Quoted from the abstract of N Engl J Med 1998, checked word for word against PubMed. PubMed 9841303 · Full paper (DOI)
How this medicine works, where it stands and what it costs: Statins
Common questions
What did the LIPID trial find?
In patients with coronary heart disease and a broad range of cholesterol levels, pravastatin reduced death from coronary heart disease, overall mortality, and other cardiovascular events compared with placebo.
Who was in LIPID?
9,014 people. Patients 31 to 75 years of age with a history of myocardial infarction or hospitalization for unstable angina and initial plasma total cholesterol levels of 155 to 271 mg per deciliter.
What was LIPID's main result?
Death from coronary heart disease occurred in 8.3 percent of the patients in the placebo group and 6.4 percent of those in the pravastatin group, a relative reduction in risk of 24 percent (95 percent confidence interval, 12 to 35 percent; P<0.001).
How much did LDL cholesterol change in LIPID?
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Related trials
- AFCAPS/TexCAPS (1998)In men and women with average cholesterol but low HDL-C and no known heart disease, lovastatin substantially lowered the risk of a first major coronary event.
- CARE (1996)In patients with average cholesterol levels after myocardial infarction, pravastatin significantly reduced the risk of fatal coronary events and nonfatal MI, as well as the need for revascularization and stroke, without a significant effect on overall mortality.
- WOSCOPS (1995)In middle-aged men with moderate hypercholesterolemia and no prior MI, pravastatin significantly reduced coronary events and cardiovascular death without increasing noncardiovascular deaths.
- 4S (1994)In patients with coronary heart disease and elevated cholesterol, simvastatin reduced the risk of death and major coronary events compared with placebo over about 5.4 years.
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