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afya Lipid Trials

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20160425222523 Ben  
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''4S trial''
1994 Scandinavian Simvastatin Survival Study
double-blind RCT
secondary prevention CVD
Pts with IHD and chol 5.5-8.0 - given simvastatin or placebo
Result - Total mortality dec by 30%, IHD mortality dec by 42%, no inc in non-CVD death

''WOSCOPS''
1995 West of Scotland Coronary Prevention Study 
RCT men 45-64 no Hx IHD with raised chole (>6.5)
given pravastatin or placebo
Result - total mortality dec by 22%, IHD mortality dec by 31%

''Heart Protection Study''
2002 MRC RCT (20,000pts)	
40 - 80 yrs with 'substantial' 5yr IHD mortality risk (Hx vascular disease, HT or diabetes)
Simvastatin 40, antioxidants (600 mg vit E, 250 mg vit C, 20 mg beta-carotene daily), placebo or combination
Results - NNT  to prevent all cause death = 57, IHD death = 85, vascular event = 19,  major coronary event = 33,  stroke = 73
vascular events reduced by 25%
antioxidants did not affect clinical outcome