Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER).
<h4>Background</h4>The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), a placebo-controlled trial of pravastatin, demonstrated a 19% reduction in coronary outcomes (p=0.006) after a mean of 3.2 years, with no impact on stroke outcomes or all-cause mortality. However, t...
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2013-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0072642 |
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| author | Suzanne M Lloyd David J Stott Anton J M de Craen Patricia M Kearney Naveed Sattar Ivan Perry Christopher J Packard Andrew Briggs Laura Marchbank Harry Comber J Wouter Jukema Rudi G J Westendorp Stella Trompet Brendan M Buckley Ian Ford |
| author_facet | Suzanne M Lloyd David J Stott Anton J M de Craen Patricia M Kearney Naveed Sattar Ivan Perry Christopher J Packard Andrew Briggs Laura Marchbank Harry Comber J Wouter Jukema Rudi G J Westendorp Stella Trompet Brendan M Buckley Ian Ford |
| author_sort | Suzanne M Lloyd |
| collection | DOAJ |
| description | <h4>Background</h4>The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), a placebo-controlled trial of pravastatin, demonstrated a 19% reduction in coronary outcomes (p=0.006) after a mean of 3.2 years, with no impact on stroke outcomes or all-cause mortality. However, there was a suggestion of increased cancer risk. Our aim is to determine the long-term benefits and safety of pravastatin treatment in older people using post-trial follow-up of the PROSPER participants.<h4>Methods</h4>5,804 (2,520 Scottish) men and women aged 70-82 years with either pre-existing vascular disease or increased risk of such disease because of smoking, hypertension or diabetes, were randomised to 40 mg pravastatin or matching placebo. Using record linkage to routinely collected health records, all participants (full cohort) were linked to death and cancer registries, and the Scottish cohort additionally to hospital admissions, to provide composite fatal/non-fatal cardiovascular outcomes (total mean follow-up 8.6 years).<h4>Results</h4>Pravastatin treatment for 3.2 years reduced CHD death in the full cohort, hazard ratio (HR) 0.80, 95% confidence interval (CI) 0.68-0.95, p=0.0091 and fatal coronary events or coronary hospitalisations in the Scottish cohort (HR 0.81, 95% CI 0.69-0.95, p=0.0081) over 8.6 years. There was no reduction in stroke or all-cause mortality. Cancer risk was not increased in the full cohort (HR 1.08, 95% CI 0.96-1.21, p=0.22).<h4>Conclusions</h4>Pravastatin treatment of elderly high-risk subjects for 3.2 years provided long-term protection against CHD events and CHD mortality. However, this was not associated with any increase in life expectancy, possibly due to competing mortality with deaths from other causes. There was no evidence of long-term increased risk of cancer.<h4>Trial registration</h4>ISRCTN40976937. |
| format | Article |
| id | doaj-art-1f2629ed3a204cf4a3af1f2e756f1923 |
| institution | Kabale University |
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| language | English |
| publishDate | 2013-01-01 |
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| spelling | doaj-art-1f2629ed3a204cf4a3af1f2e756f19232025-08-20T03:46:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0189e7264210.1371/journal.pone.0072642Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER).Suzanne M LloydDavid J StottAnton J M de CraenPatricia M KearneyNaveed SattarIvan PerryChristopher J PackardAndrew BriggsLaura MarchbankHarry ComberJ Wouter JukemaRudi G J WestendorpStella TrompetBrendan M BuckleyIan Ford<h4>Background</h4>The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), a placebo-controlled trial of pravastatin, demonstrated a 19% reduction in coronary outcomes (p=0.006) after a mean of 3.2 years, with no impact on stroke outcomes or all-cause mortality. However, there was a suggestion of increased cancer risk. Our aim is to determine the long-term benefits and safety of pravastatin treatment in older people using post-trial follow-up of the PROSPER participants.<h4>Methods</h4>5,804 (2,520 Scottish) men and women aged 70-82 years with either pre-existing vascular disease or increased risk of such disease because of smoking, hypertension or diabetes, were randomised to 40 mg pravastatin or matching placebo. Using record linkage to routinely collected health records, all participants (full cohort) were linked to death and cancer registries, and the Scottish cohort additionally to hospital admissions, to provide composite fatal/non-fatal cardiovascular outcomes (total mean follow-up 8.6 years).<h4>Results</h4>Pravastatin treatment for 3.2 years reduced CHD death in the full cohort, hazard ratio (HR) 0.80, 95% confidence interval (CI) 0.68-0.95, p=0.0091 and fatal coronary events or coronary hospitalisations in the Scottish cohort (HR 0.81, 95% CI 0.69-0.95, p=0.0081) over 8.6 years. There was no reduction in stroke or all-cause mortality. Cancer risk was not increased in the full cohort (HR 1.08, 95% CI 0.96-1.21, p=0.22).<h4>Conclusions</h4>Pravastatin treatment of elderly high-risk subjects for 3.2 years provided long-term protection against CHD events and CHD mortality. However, this was not associated with any increase in life expectancy, possibly due to competing mortality with deaths from other causes. There was no evidence of long-term increased risk of cancer.<h4>Trial registration</h4>ISRCTN40976937.https://doi.org/10.1371/journal.pone.0072642 |
| spellingShingle | Suzanne M Lloyd David J Stott Anton J M de Craen Patricia M Kearney Naveed Sattar Ivan Perry Christopher J Packard Andrew Briggs Laura Marchbank Harry Comber J Wouter Jukema Rudi G J Westendorp Stella Trompet Brendan M Buckley Ian Ford Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). PLoS ONE |
| title | Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). |
| title_full | Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). |
| title_fullStr | Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). |
| title_full_unstemmed | Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). |
| title_short | Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). |
| title_sort | long term effects of statin treatment in elderly people extended follow up of the prospective study of pravastatin in the elderly at risk prosper |
| url | https://doi.org/10.1371/journal.pone.0072642 |
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