Fluvastatin reduces the 4-year cardiac risk in patients with multivessel disease.
BACKGROUND
To evaluate the impact of the extent of coronary disease (single- or multivessel) and of fluvastatin treatment on the incidence of long-term cardiac atherosclerotic complications in the Lescol Intervention Prevention Study (LIPS).


METHODS
A total of 1063 patients with single-vessel disease and 614 patients with multivessel disease were randomized to receive fluvastatin (40 mg bid) or placebo for at least 3 years following a first successful percutaneous coronary intervention. The incidence of cardiac atherosclerotic events (cardiac death, non-fatal myocardial infarction, and coronary re-interventions not related to restenosis) was evaluated.


RESULTS
Patients with multivessel disease tended to be older and presented a higher prevalence of associated risk factors and cardiovascular antecedents. The presence of multivessel disease markedly increased the risk of cardiac atherosclerotic events compared with single-vessel disease among patients allocated to placebo (RR 1.67 [95% CI: 1.24-2.25]; p<0.001). In patients treated with fluvastatin, however, no significant differences in long-term outcomes were observed between patients with multivessel disease and patients single-vessel disease (RR 1.28 [95% CI: 0.90-1.81]; p=0.2).


CONCLUSIONS
Multivessel coronary disease impaired the 4-year outcomes after percutaneous intervention. However, the hazardous effect of multivessel disease was significantly reduced by long-term fluvastatin treatment.
Lemos
Pedro A
PA
Erasmus Medical Center, Thoraxcenter, Rotterdam, Netherlands.
de Feyter
Pim J
PJ
Serruys
Patrick W
PW
Saia
Francesco
F
Arampatzis
Chourmouzios A
CA
Disco
Clemens
C
Mercado
Nestor
N
Mainar
Vicente
V
Morís
César
C
van den Bos
A A
AA
Berghoefer
Gunnar
G
D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000453:epidemiology; D003327:Coronary Disease / Q000188:drug therapy* / Q000628:therapy; D005229:Fatty Acids, Monounsaturated / Q000627:therapeutic use*; D000077340:Fluvastatin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007211:Indoles / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D015607:Stents
D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D000077340:Fluvastatin