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December 16, 1997Circulation

Cholesterol-Lowering Therapy in Women and Elderly Patients With Myocardial Infarction or Angina Pectoris

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Why the study?

Does simvastatin 20 to 40 mg daily reduce mortality and major coronary events in women and elderly patients with established coronary heart disease?

Population

4,444 patients with established coronary heart disease, including 827 women and 1,021 patients >= 65 years…

Comparison

Simvastatin 20 to 40 mg daily vs Placebo

Design

RCT, randomized

Follow-up

median 5.4 years

Authors

TMTatu A. MiettinenTakeda (France)KPKalevi PyörälàPreventive CardiologyAOAnders OlssonKarolinska Institutet

Discussion

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Member takes

Implication

Supports simvastatin in elderly patients and women with CHD; extends RCT evidence to these subgroups.

Structured PICO

Does simvastatin 20 to 40 mg daily reduce mortality and major coronary events in women and elderly patients with established coronary heart disease?

P
Population
4,444 patients with established coronary heart disease (myocardial infarction or angina pectoris), including 827 women and 1,021 patients >= 65 years of age, with baseline total cholesterol 5.5 to 8.0 mmol/L and triglycerides <= 2.5 mmol/L
I
Intervention
Simvastatin 20 to 40 mg daily
C
Comparator
Placebo
O
Outcome
All-cause and CHD mortality, major coronary events (primarily CHD death and nonfatal myocardial infarction)hard clinical

Simvastatin therapy significantly reduces major coronary events in women and elderly patients with established coronary heart disease, with older patients experiencing substantial absolute risk reductions in mortality.

Limitations

  • Post hoc assessment
  • Too few female deaths to assess the effects on mortality in women

Cite This Study

Miettinen et al. (1997) studied this question.

synapsesocial.com/papers/6a800b644fef96f46ad47c04https://doi.org/10.1161/01.cir.96.12.4211
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Also Consider

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  1. 1Ischaemic Heart Disease: A Secondary Prevention Trial Using Clofibrate1971 · 242 citations
  2. 2Lewis A. Conner Memorial Lecture. Mechanisms leading to myocardial infarction: insights from studies of vascular biology.1994 · 856 citations
  3. 3Reduction of Mortality in the Stockholm Ischaemic Heart Disease Secondary Prevention Study by Combined Treatment with Clofibrate and Nicotinic Acid1988 · 684 citations
  4. 4Regression Models and Life-Tables1972 · 39,949 citations
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