WOSCOPS: Lifetime Clinical and Economic Benefits of Statin-Based LDL Lowering in 20-Year Follow-Up

The benefit of a risk reduction in cardiovascular disease outcomes from a five year statin-based LDL lowering is evident over a 20 year period, according to 20-year follow-up results of the WOSCOPS trial presented Nov. 18 at AHA 2014.

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While the initial WOSCOPS trial looked at 6,595 men who were randomized to 40mg/d of pravastatin or placebo, the 20-year follow-up study, led by Chris J. Packard, MD, University of Glasgow, examined the long-term (lifetime) clinical and economic benefits of statin-based LDL lowering. The study looked at linked records within the Scotland and UK death registers, cancer registries, and all hospitalizations from the NHS National Services Scotland Information Services Division.

Results showed over entire 20-year period, there was a 27 percent risk reduction of coronary heart disease mortality (P<0.001), and a 13 percent risk reduction in all-cause mortality (P<0.001) in the patients randomized to pravastatin, as compared to the patients randomize to placebo. The investigators note that “statin therapy is ‘cost-saving’ over long term in primary prevention,” since 2,457 cardiovascular events occurred in 1,044 patients in the pravastatin group, vs. 3,007 cardiovascular events in 1,209 patients in the placebo group (P<0.0001).

The investigators add that the “20 year period of follow up for WOSCOPS covers the age range (mean age 55 to 75 years) when premature cardiovascular disease occurs and so lifetime benefit can be estimated.” They conclude that non-cardiovascular events and cancers showed equal incidence rates in active and placebo treated arms. Further, the lifetime benefits can be estimated for various degrees of LDL reduction.

Keywords: Coronary Artery Disease, Neoplasms, Follow-Up Studies, Risk Reduction Behavior, Scotland, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Information Services, Pravastatin

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