West of Scotland Coronary Prevention Studie (WOS-Studie),Newsletter Kardiologie aktuell

Blutfettsenker Pravastatin senkt Herz-Kreislaufrisiko:
In der West of Scotland Coronary Prevention Studie (WOS-Studie)wurde die Wirkung das Blutfettsenkers Pravastatin mit der Gabe eines Placebo verglichen. Untersucht wurden Männer die zwar unter einer Hypercholesterinämie litten - aber keinen Herzinfarkt hatten. Nun - rund zehn Jahre nach Ende der Studie - wurden die für diesen Zeitraum verfügbaren Daten analysiert. Es zeigte sich, dass das Risiko an einer Herzerkrankung zu sterben in der Pravastatin-Gruppe bei 11.8% und in der Placebo-Gruppe bei 15.5% lag. (1)

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Eine englischsprachige Kurzversion dieser Studie (sog. MEDLINE Abstract) finden Sie hier

N Engl J Med. 2007 Oct 11;357(15):1477-86.


Comment in:: N Engl J Med. 2007 Oct 11;357(15):1543-5.

Long-term follow-up of the West of Scotland Coronary Prevention Study.

Ford I, Murray H, Packard CJ, Shepherd J, Macfarlane PW, Cobbe SM; West of Scotland Coronary Prevention Study Group.

Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom.

BACKGROUND: The West of Scotland Coronary Prevention Study was a randomized clinical trial comparing pravastatin with placebo in men with hypercholesterolemia who did not have a history of myocardial infarction, with an average follow-up of approximately 5 years. The combined outcome of death from definite coronary heart disease or definite nonfatal myocardial infarction was reduced from 7.9 to 5.5% (P<0.001) in the treatment group. Extended follow-up data were obtained for approximately 10 years after completion of the trial.

METHODS: For the survivors of the trial, all deaths, hospitalizations and deaths due to coronary events and stroke, and incident cancers and deaths from cancer were tracked with the use of a national computerized record-linkage system. The results were analyzed with time-to-event analyses and use of Cox proportional-hazards models.

RESULTS: Five years after the trial ended, 38.7% of the original statin group and 35.2% of the original placebo group were being treated with a statin. In the period approximately 10 years after completion of the trial, the risk of death from coronary heart disease or nonfatal myocardial infarction was 10.3% in the placebo group and 8.6% in the pravastatin group (P=0.02); over the entire follow-up period, the rate was 15.5% in the placebo group and 11.8% in the pravastatin group (P<0.001). Similar percentage reductions were seen in the combined rate of death from coronary heart disease and hospitalization for coronary events for both periods. The rate of death from cardiovascular causes was reduced (P=0.01), as was the rate of death from any cause (P=0.03), over the entire follow-up period. There were no excess deaths from noncardiovascular causes or excess fatal or incident cancers.

CONCLUSIONS: In this analysis, 5 years of treatment with pravastatin was associated with a significant reduction in coronary events for a subsequent 10 years in men with hypercholesterolemia who did not have a history of myocardial infarction.

PMID: 17928595 [PubMed - indexed for MEDLINE]