title: Pravastatin reduces the incidence of cardiac events among patients with myocardial infarction.
abstract: We retrospectively compared the incidence of cardiac events in myocardial infarction (MI) patients treated in our departments between 1990 and 1999 with pravastatin or without cholesterol-lowering agents. Our aim was to evaluate the efficacy of pravastatin in the secondary prevention of MI. Cardiac events--defined as fatal or nonfatal recurrent MI, sudden cardiac death, and death from congestive heart failure--occurred in 8 (2.2%) of 356 MI patients treated with pravastatin (17.1 cases/1.000 person x year) and in 39 (5.6%) of 700 MI patients not treated with cholesterol-lowering agents (54.3 cases/1000 person x year), which represented a significant decline among those taking pravastatin (P < 0.05, odds ratio: 0.39, 95% (CI: 0.18-0.84). Likewise, total mortality was significantly lower among patients treated with pravastatin (18 cases, 5.1%; 38.4 cases/1,000 person x year vs 77 cases, 11.0%; 107.2 cases/1,000 person x year, P < 0.01, odds ratio: 0.43, 95% CI: 0.25-0.73). Subgroup analysis revealed a significantly lower incidence or cardiac events in the pravastatin group for 6 of the items among 53 patient characteristics, and was lower but not significant for 45 items and was greater but not significant only for 2 items. Furthermore, multivariate analysis confirmed pravastatin to be a useful factor for preventing the occurrence of cardiac events in MI patients (P < 0.05, odds ratio: (0.44, 95% CI: 0.20-0.95), and Kaplan-Meier curves also showed pravastatin to significantly reduce the incidence of both cardiac events and total mortality. These findings are consistent with those previously reported by several large-scale clinical trials carried out in Western countries, and demonstrate that pravastatin is useful for secondary prevention of MI in Japanese patients.
authors.affiliation: Department of Cardiology, Kinki University School of Medicine, Osaka, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Furuta
authors.forename: Akio
authors.initials: A
authors.lastname: Kimura
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyataka
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Katayama
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Takenaka
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hayashi
authors.forename: Ken
authors.initials: K
authors.lastname: Kanamasa
authors.forename: Kinji
authors.initials: K
authors.lastname: Ishikawa
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D017035:Pravastatin / Q000627:therapeutic use*; D012189:Retrospective Studies; D055502:Secondary Prevention
chemical_list: D000924:Anticholesteremic Agents; D017035:Pravastatin