Relationship between lipid levels and clinical outcomes in the long-term intervention with pravastatin in ischemic disease (LIPID) trial. To what extent is the reduction in coronary events with pravastatin explained by on-study lipid levels?

Simes, R. John; Marschner, Ian C.; Hunt, D

doi:10.1016/s1062-1458(02)00772-9

Cited by 75 publications

(98 citation statements)

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“…The relationships between LDL-C and coronary events and stroke observed in this study are similar to those reported for coronary events 27,[30][31][32] and cerebral events. [33][34][35] The Japan Lipid Intervention Trial (J-LIT), an observational study with simvastatin, similarly showed that the incidence of coronary artery disease reaches a plateau level at LDL-C around 120-140 mg/dL in a primary prevention setting.…”

Section: Discussionsupporting

confidence: 89%

The Relationship Between Low-Density Lipoprotein Cholesterol Levels and the Incidence of Cardiovascular Disease in High-Risk Patients Treated With Pravastatin

et al. 2014

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on behalf of the APPROACH-J Study Group SummaryThis study aimed to evaluate the relationship between low-density lipoprotein cholesterol (LDL-C) levels and cardiovascular disease (CVD) in high-risk patients with hypercholesterolemia without a history of CVD. Patients who were receiving or started treatment with pravastatin, were followed-up for 2 years. Patients were divided into quartiles according to on-treatment LDL-C. The maximum contrast method based on the Cox proportional hazards model was used to evaluate the relationship between achieved LDL-C and the incidence of CVD. Incidence of CVD was also compared according to whether a number of risk factor targets were achieved. A total 6,229 patients were enrolled, with 4,916 having reported LDL-C values. During the 2 years, 69 cases of CVD (6.7/1000 patient years), including 36 coronary artery disease (CAD) (3.5/1000 patient years) and 28 strokes (2.7/1000 patient years), occurred. The comparison of on-treatment LDL-C level quartiles suggested that the incidence of all CVD decreased linearly as the LDL-C levels decreased. Incidence of CAD showed a curvilinear relationship to LDL-C levels, suggesting some attenuation of risk below LDL-C of 119 mg/dL. The incidence of all CVD and CAD tended to be decreased as the number of achieved risk factor targets increased. In conclusion, through our observational study, it was shown that a linear relationship between the incidence of CVD and LDL-C was observed in high-risk hypercholesterolemic patients. The low incidence of CVD in the present study may be associated with multifactorial management of conventional risk factors including high LDL-C levels. However, prospective, randomized studies are needed to confi rm these fi ndings. (Int Heart J 2014; 55: 39-47)

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Section: Discussionsupporting

confidence: 89%

The Relationship Between Low-Density Lipoprotein Cholesterol Levels and the Incidence of Cardiovascular Disease in High-Risk Patients Treated With Pravastatin

et al. 2014

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“…25,[27][28][29][30][31][32][33][34] Thus, the analyses presented are limited to C-reactive protein (CRP), hemoglobin A1C (hgA1C), and high-density lipoprotein (HDL) cholesterol.…”

Section: Blood Specimen Collection and Assaysmentioning

confidence: 99%

Neighborhood Socioeconomic Status in Relation to Serum Biomarkers in the Black Women’s Health Study

et al. 2016

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Lower neighborhood socioeconomic status (SES) is associated with higher cardiovascular disease (CVD) risk. Black women have a higher CVD risk and are more likely to live in poor neighborhoods than white women. We examined the association of neighborhood SES with several CVD biomarkers using data from the Black Women's Health Study (BWHS), a follow-up study of US black women reporting high levels of education and income. Blood specimens of 418 BWHS participants were assayed for Creactive protein (CRP), hemoglobin A1C (hgA1C), and high-density lipoprotein (HDL) cholesterol. US Census block group data were linked to the women's addresses to reflect neighborhood SES. Multivariable-adjusted mixed linear regression models that adjusted for person-level SES and for cardiovascular risk factors were used to assess CRP, hgA1C, and HDL levels in relation to quintiles of neighborhood SES. Women living in the poorest neighborhoods had the least favorable biomarker levels. As neighborhood SES increased, CRP decreased (P for trend = 0.01), hgA1C decreased (P for trend = 0.07), and HDL increased (P for trend = 0.19). These associations were present within strata of individual educational level. The present findings suggest that neighborhood environments may affect physiological processes within residents independently of individual SES.

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“…The ratio of total to HDL cholesterol was chosen for this analysis because it was the strongest lipid predictor of coronary events in the LIPID Study 26 ; however, the reduction in CHD mortality and cardiovascular events with pravastatin treatment was similar in patients with higher and lower ratios of total to HDL cholesterol. This finding is consistent with those of other large statin trials in which the relative risk reduction was similar in subjects with high, average, and low LDL cholesterol levels.…”

Section: Stewart Et Al White Blood Count Pravastatin Coronary Mortamentioning

confidence: 99%

White Blood Cell Count Predicts Reduction in Coronary Heart Disease Mortality With Pravastatin

et al. 2005

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Background-Elevated serum inflammatory marker levels are associated with a greater long-term risk of cardiovascular events. Because 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors (statins) may have an antiinflammatory action, it has been suggested that patients with elevated inflammatory marker levels may have a greater reduction in cardiovascular risk with statin treatment. Methods and Results-We evaluated the association between the white blood cell count (WBC) and coronary heart disease mortality during a mean follow-up of 6.0 years in the Long-Term Intervention With Pravastatin in Ischemic Disease (LIPID) Study, a clinical trial comparing pravastatin (40 mg/d) with a placebo in 9014 stable patients with previous myocardial infarction or unstable angina. An increase in baseline WBC was associated with greater coronary heart disease mortality in patients randomized to placebo (hazard ratio for 1ϫ10 9 /L increase in WBC, 1.18; 95% CI, 1.12 to 1.25; PϽ0.001) but not pravastatin (hazard ratio, 1.02; 95% CI, 0.96 to 1.09; Pϭ0.56; P for interactionϭ0.004). The numbers of coronary heart disease deaths prevented per 1000 patients treated with pravastatin were 0, 9, 30, and 38 for baseline WBC quartiles of Ͻ5.9, 6.0 to 6.9, 7.0 to 8.1, and Ͼ8.2ϫ10 9 /L, respectively. WBC was a stronger predictor of this treatment benefit than the ratio of total to high-density lipoprotein cholesterol and a global measure of cardiac risk. There was also a greater reduction (Pϭ0.052) in the combined incidence of cardiovascular mortality, nonfatal myocardial infarction, and stroke with pravastatin as baseline WBC increased (by quartile: 3, 41, 61, and 60 events prevented per 1000 patients treated, respectively). Conclusions-These

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Relationship between lipid levels and clinical outcomes in the long-term intervention with pravastatin in ischemic disease (LIPID) trial. To what extent is the reduction in coronary events with pravastatin explained by on-study lipid levels?

Cited by 75 publications

References 0 publications

The Relationship Between Low-Density Lipoprotein Cholesterol Levels and the Incidence of Cardiovascular Disease in High-Risk Patients Treated With Pravastatin

The Relationship Between Low-Density Lipoprotein Cholesterol Levels and the Incidence of Cardiovascular Disease in High-Risk Patients Treated With Pravastatin

Neighborhood Socioeconomic Status in Relation to Serum Biomarkers in the Black Women’s Health Study

White Blood Cell Count Predicts Reduction in Coronary Heart Disease Mortality With Pravastatin

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