WOSCOPS研究课件（PPT 18页）.ppt

Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia James Shepherd, M.D., Stuart M. Cobbe, M.D., Ian Ford, Ph.D., Christopher G. Isles., M.D., A. Ross Lorimer, M.D., Peter W. Macfarlane, Ph. D., James H. McKillop, M.D., and Christopher J. Packard, D. Sc., for the West of Scotland Coronary Prevention Study Group Background This double-blind study was designed to determine whether the administration of pravastatin to men with hypercholesterolemia and no history of myocardial infarction reduced the combined incidence of nonfatal myocardial infarction and death from coronary heart disease West of Scotland Coronary Prevention Study Group (WOS) Randomized, double-blind, placebo controlled 6595 men, 45 to 64 years of age Average follow-up of 4.9 years (seen at 3 month intervals) Pravastatin (40 mg each evening) vs. placebo WOSBaseline Characteristics Mean lipid levels: TC = 272 mg/dL LDL = 192 mg/dL HDL = 44 mg/dL Trigs = 162-164 mg/dL 5% of patients with angina 3% of patients with claudication 8% of patients with abnormal EKG 44% current smokers, 34% ex-smokers Endpoints Primary Non-fatal MI or coronary heart disease death as a first event Secondary Non-fatal MI Coronary heart disease death Other Endpoints Cardiovascular mortality Total mortality Coronary revascularization procedures WOSReduction in Lipids Pravastatin reduced lipid levels by*: 20% reduction in TC 26% reduction in LDL 12% reduction in Trigs 5% increase in HDL Effects of Pravastatin Therapy on Plasma LDL Cholesterol Levels Nonfatal MI or CHD Death(Primary Endpoint) Non-Fatal MI(Secondary Endpoint) CHD Death(Secondary Endpoint) Cardiovascular Death Coronary Interventions Intervention Placebo Pravastatin Risk (n= 3293) (n=3302) Reductions p-value Coronary Angiography 128 90 31% 0.007 PTCA / CABG 80 51 37% 0.009 Total Mortality WOS Results/Clinical Events WOSConclusi