Evidence mapPaperPMID 24023757Full record

Trial reportPloS one2013

Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER).

Suzanne M Lloyd, David J Stott, Anton J M de Craen, Patricia M Kearney, Naveed Sattar, Ivan Perry, Christopher J Packard, Andrew Briggs, Laura Marchbank, Harry Comber and 5 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 pooled it
4.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 62 citations in OpenAlex.

  1. Guideline
  2. Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2019
    Guideline
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Review
  7. Article
  8. Microvascular Health as a Key Determinant of Organismal Aging.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025
    Review
  9. Article
  10. Management of patients with statin intolerance.Best practice & research. Clinical endocrinology & metabolism · 2023
    Review
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Gender differences in mortality among statin users aged 80 years or more.Zeitschrift fur Gerontologie und Geriatrie · 2018
    Article
  17. Safety and Effectiveness of Statins for Prevention of Recurrent Myocardial Infarction in 12 156 Typical Older Patients: A Quasi-Experimental Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2017 · on this map
    Article
  18. Article
  19. Article
  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 3 countries.

Suzanne M LloydRobertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom.
David J Stott
Anton J M de Craen
Patricia M Kearney
Naveed Sattar
Ivan Perry
Christopher J Packard
Andrew Briggs
Laura Marchbank
Harry Comber
J Wouter Jukema
Rudi G J Westendorp
Stella Trompet
Brendan M Buckley
Ian Ford
University of Glasgow · GBLeiden University Medical Center · NLUniversity College Cork · IENational Cancer Registry · IENational Health Service Scotland · GBNHS Greater Glasgow and Clyde · GB

Funding

Chief Scientist Office CZH/4/637Wellcome Trust
6 · The paper itself

Abstract

backgroundThe 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.

methods5,804 (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).

resultsPravastatin 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).

conclusionsPravastatin 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.

trial registrationISRCTN40976937.

Indexed as

AgedAged, 80 and overCoronary DiseaseFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleNetherlandsPravastatinProspective StudiesHydroxymethylglutaryl-CoA Reductase InhibitorsPravastatin

Identifiers

PMID24023757
PMCPMC3759378
OpenAlexW2104439301

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.