Reduction of stroke events with pravastatin - The Prospective Pravastatin Pooling (PPP) Project

Byington, R., Davis, B., Plehn, J., White, H., Baker, J., Cobbe, S. and Shepherd, J. (2001) Reduction of stroke events with pravastatin - The Prospective Pravastatin Pooling (PPP) Project. Circulation, 103(3), pp. 387-392.

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Abstract

Background-Stroke is a leading cause of death and disability. Although clinical trials of the early lipid-lowering therapies did not demonstrate a reduction in the rates of stroke, data from recently completed statin trials strongly suggest benefit. Methods and Results-The effect of pravastatin 40 mg/d on stroke events was investigated in a prospectively defined pooled analysis of 3 large, placebo-controlled, randomized trials that included 19 768 patients with 102 559 person-years of follow-up. In all, 598 participants had a stroke during approximate to5 years of follow-up. The 2 secondary prevention trials (CARE [Cholesterol And Recurrent Events] and LIPID [Long-term Intervention with Pravastatin in Ischemic Disease]) individually demonstrated reductions in nonfatal and total stroke rates. When the 13 173 patients from CARE and LIPID were combined, there was a 22% reduction in total strokes (95% CI 7% to 35%, P=0.01) and a 25% reduction in nonfatal stroke (95% CI 10% to 38%). The beneficial effect of pravastatin on total stroke was observed across a wide range of patient characteristics. WOSCOPS (West of Scotland Coronary Prevention Study, a primary prevention trial in hypercholesterolemic men) exhibited a similar, although smaller, trend for a reduction in total stroke. Among the CARE/LIPID participants, pravastatin was associated with a 23% reduction in nonhemorrhagic strokes (95% CI 6% to 37%), but there was no statistical treatment group difference in hemorrhagic or unknown type. Conclusions-Pravastatin reduced the risk of stroke over a wide range of lipid values among patients with documented coronary disease. This effect was due to a reduction in nonfatal nonhemorrhagic strokes.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Shepherd, Prof James and Cobbe, Professor Stuart
Authors: Byington, R., Davis, B., Plehn, J., White, H., Baker, J., Cobbe, S., and Shepherd, J.
College/School:College of Medical Veterinary and Life Sciences
Journal Name:Circulation
ISSN:0009-7322

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