ORLANDO-Healthy people with unexceptional lipid levels may reduce risks of MI or unstable angina with a cholesterol-lowering drug.
The first primary-prevention trial in middle-aged men and women found that lovastatin (Mevacor, Merck) cut risks of a first coronary event by a third.
In the five-year Air Force-Texas Atherosclerosis Prevention Study, which randomized 6,605 healthy adults to the statin or placebo, 267 people had a fatal or nonfatal MI, sudden cardiac death, or unstable angina.
But treated volunteers, whose average total cholesterols fell to 184 mg/dL from an average of 221 mg/dL, were 36% less likely to have a coronary event, said Dr. Antonio Gotto, chairman of the steering committee. Women’s risk fell 54% and men’s 34%.
Benefits for those taking lovastatin included a one-third drop in the need for revascularization procedures. There were 16 cardiac deaths in the lovastatin group and 20 among controls.
Participants began with a mean LDL of 150 mg/dL (a range of 130 to 190), which a mean dose of 30 mg/day of lovastatin dropped to 115 mg/dL, Dr. Gotto told the American Heart Association meeting here. Both groups started on a low-fat diet and exercise. HDL levels for all were under 50, a mean of 37. All had at least one risk factor.
Dr. Gotto, who is dean of Cornell, said only 17% of trial participants would have qualified for statin treatment under guidelines of the National Cholesterol Education Program.
He predicted that nearly seven million Americans not now indicated in NCEP guidelines for statins might benefit. But he added that 55 patients would need to be treated for five years to prevent one event. -Judy Ismach
ORLANDO-Healthy people with unexceptional lipid levels may reduce risks of MI or unstable angina with a cholesterol-lowering drug.
