Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER)
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 increa...
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| Veröffentlicht in: | PloS one 2013-09, Vol.8 (9), p.e72642 |
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| creator | Lloyd, Suzanne M Stott, David J de Craen, Anton J M Kearney, Patricia M Sattar, Naveed Perry, Ivan Packard, Christopher J Briggs, Andrew Marchbank, Laura Comber, Harry Jukema, J Wouter Westendorp, Rudi G J Trompet, Stella Buckley, Brendan M Ford, Ian |
| description | 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.
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).
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).
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.
ISRCTN40976937. |
| doi_str_mv | 10.1371/journal.pone.0072642 |
| format | Article |
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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).
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).
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.
ISRCTN40976937.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0072642</identifier><identifier>PMID: 24023757</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Aged, 80 and over ; Cancer ; Cardiovascular disease ; Collaboration ; Complications and side effects ; Confidence intervals ; Coronary Disease - drug therapy ; Coronary Disease - mortality ; Coronary heart disease ; Demographic aspects ; Diabetes mellitus ; Dosage and administration ; Elderly patients ; Female ; Geriatrics ; Health aspects ; Health risk assessment ; Health risks ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Hypertension ; Life expectancy ; Life span ; Long-term effects ; Low density lipoprotein ; Male ; Mathematics ; Medicine ; Mortality ; Netherlands ; Older people ; Physiological aspects ; Pravastatin ; Pravastatin - adverse effects ; Pravastatin - therapeutic use ; Prospective Studies ; Reduction ; Risk factors ; Risk management ; Smoking ; Statins ; Vascular diseases</subject><ispartof>PloS one, 2013-09, Vol.8 (9), p.e72642</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Lloyd et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Lloyd et al 2013 Lloyd et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c622t-4bcd48e6a425a8554d710e8c87d03254b739b55cd9832e8b53135e9a9059402d3</citedby><cites>FETCH-LOGICAL-c622t-4bcd48e6a425a8554d710e8c87d03254b739b55cd9832e8b53135e9a9059402d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3759378/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3759378/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24023757$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lloyd, Suzanne M</creatorcontrib><creatorcontrib>Stott, David J</creatorcontrib><creatorcontrib>de Craen, Anton J M</creatorcontrib><creatorcontrib>Kearney, Patricia M</creatorcontrib><creatorcontrib>Sattar, Naveed</creatorcontrib><creatorcontrib>Perry, Ivan</creatorcontrib><creatorcontrib>Packard, Christopher J</creatorcontrib><creatorcontrib>Briggs, Andrew</creatorcontrib><creatorcontrib>Marchbank, Laura</creatorcontrib><creatorcontrib>Comber, Harry</creatorcontrib><creatorcontrib>Jukema, J Wouter</creatorcontrib><creatorcontrib>Westendorp, Rudi G J</creatorcontrib><creatorcontrib>Trompet, Stella</creatorcontrib><creatorcontrib>Buckley, Brendan M</creatorcontrib><creatorcontrib>Ford, Ian</creatorcontrib><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><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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).
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).
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.
ISRCTN40976937.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer</subject><subject>Cardiovascular disease</subject><subject>Collaboration</subject><subject>Complications and side effects</subject><subject>Confidence intervals</subject><subject>Coronary Disease - drug therapy</subject><subject>Coronary Disease - mortality</subject><subject>Coronary heart disease</subject><subject>Demographic aspects</subject><subject>Diabetes mellitus</subject><subject>Dosage and administration</subject><subject>Elderly patients</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Hypertension</subject><subject>Life expectancy</subject><subject>Life span</subject><subject>Long-term effects</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Mathematics</subject><subject>Medicine</subject><subject>Mortality</subject><subject>Netherlands</subject><subject>Older people</subject><subject>Physiological aspects</subject><subject>Pravastatin</subject><subject>Pravastatin - adverse effects</subject><subject>Pravastatin - therapeutic use</subject><subject>Prospective Studies</subject><subject>Reduction</subject><subject>Risk factors</subject><subject>Risk management</subject><subject>Smoking</subject><subject>Statins</subject><subject>Vascular 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Laura</au><au>Comber, Harry</au><au>Jukema, J Wouter</au><au>Westendorp, Rudi G J</au><au>Trompet, Stella</au><au>Buckley, Brendan M</au><au>Ford, Ian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER)</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-09-02</date><risdate>2013</risdate><volume>8</volume><issue>9</issue><spage>e72642</spage><pages>e72642-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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).
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).
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.
ISRCTN40976937.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24023757</pmid><doi>10.1371/journal.pone.0072642</doi><tpages>e72642</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2013-09, Vol.8 (9), p.e72642 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1429411584 |
| source | Directory of Open Access Journals (DOAJ); Public Library of Science (PLoS) Journals Open Access; MEDLINE; PubMed Central; Free Full-Text Journals in Chemistry; EZB Electronic Journals Library |
| subjects | Aged Aged, 80 and over Cancer Cardiovascular disease Collaboration Complications and side effects Confidence intervals Coronary Disease - drug therapy Coronary Disease - mortality Coronary heart disease Demographic aspects Diabetes mellitus Dosage and administration Elderly patients Female Geriatrics Health aspects Health risk assessment Health risks Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Hypertension Life expectancy Life span Long-term effects Low density lipoprotein Male Mathematics Medicine Mortality Netherlands Older people Physiological aspects Pravastatin Pravastatin - adverse effects Pravastatin - therapeutic use Prospective Studies Reduction Risk factors Risk management Smoking Statins Vascular diseases |
| 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) |
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