Evidence map›Statins × cardiovascular events›PMID 9841303›Full record

Trial reportThe New England journal of medicine1998

Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.

Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group

4 registry-linked trialsOpen access · bronzeAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 1998. The graph read 1 number from its abstract, feeding 1 cell of the map: it . It is linked to 4 registered trials, which are not on this map. Cited by 1,010 papers, 36 of them syntheses that pooled it.

1number the graph read from it
1cell of the map it votes in
1,010citing papers in PubMed, 36 pooled it
313.8field-weighted citation impact, top 1% 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.

← favours the treatmentfavours the comparator →
-29.00 · no effect
Cardiovascular eventsfavours the treatment · head-to-head · ascvd, dyslipidemiafeeds one cell of the map
reduction -29.0P<0.001
The incidence of all cardiovascular outcomes was consistently lower among patients assigned to receive pravastatin; these outcomes included myocardial infarction (reduction in risk, 29 percent; P<0.001), death from coronary heart disease or nonfatal myocardial infarction (a 24 percent reduction in risk, P<0.001), stroke (a 19 percent reduction in risk, P=0.048), and coronary revascularization (a 20 percent reduction in risk, P<0.001).
FeedsStatins×cardiovascular events

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×cardiovascular events

No readable resultOpen on the map →What to test next →

30 readable studies in this cell: 18 favour the treatment, 11 find no difference, 1 favour the comparator.

Belief with this paper
0.86replicated · 12 families support, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 1998
reduction -29.0
Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous C…PMID 29525821 · 4,191 enrolled · 2012
Δ 0.85-0.70 to 2.41
NCT002899002,340 enrolled · 2006
Δ -0.10-0.40 to 0.60
NCT01294683977 enrolled · 2011
Δ 0.00-0.97 to 0.97
NCT00728988499 enrolled · 2008
Δ 1.00-7.30 to 9.30
Pravastatin and cardiovascular risk in moderate chronic kidney disease…PMID 19423108 · 2009
RR 55.0
Effect of pravastatin on cardiovascular events in older patients with …PMID 9841599 · 1998
reduction -32.0
Cardiovascular events and their reduction with pravastatin in diabetic…PMID 9843456 · 1998
reduced -32.0
Reduced coronary events in simvastatin-treated patients with coronary …PMID 10597756
RR 0.52
Primary prevention of cardiovascular disease with atorvastatin in type…PMID 15325833
reduction -37.0-52.0 to -17.0
4 · 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.

NCT00673036 unknown statusnot on this mapstarted 2005, after this paper: background citation

French Registry of Acute Coronary Syndrome With or Without ST Elevation

TypeobservationalSponsorAssistance Publique - Hôpitaux de ParisRan2005 to 2019Enrolled3,750ConditionsAcute Myocardial InfarctionArmsBlood sample
NCT00921752 completednot on this mapstarted 2009, after this paper: background citation

C2 -CORVUS Cholesterol-Control (C2) Controlled Targets for High Vascular Risk Patients Using Effective Statins (CORVUS)

TypeobservationalSponsorAstraZenecaRan2009 to 2009Enrolled1,500ConditionsCardiovascular Risk
NCT00990834 nawithdrawnnot on this mapstarted 2009, after this paper: background citation

Muscle Characteristics Associated With Statin Therapy

TypeinterventionalSponsorScripps HealthRan2009 to 2011Enrolled0ConditionsHydroxymethylglutaryl-CoA Reductase Inhibitors, MyopathyArmssimvastatin
NCT01291641 phase4completednot on this mapstarted 2011, after this paper: background citation

Investigate Effect on Mean IMT of Probucol And/or CilosTazol in Patients With Coronary Heart dIsease Taking HMGCoA Reductase Inhibitor Therapy: A Randomized, Multicenter, Multinational Study

TypeinterventionalSponsorSeoul National University HospitalRan2011 to 2017Enrolled342ConditionsHyperlipidemiasArmsHMG-CoA Reductase Inhibitor, Probucol, Cilostazol
5 · Its place in the literature

Who cites it

1,010 citing papers in PubMed, 36 syntheses or guidelines pooled it, 5,288 citations in OpenAlex.

  1. Pooled it
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  3. Statins for the primary prevention of venous thromboembolism.The Cochrane database of systematic reviews · 2024
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  7. The association of statin therapy and cancer: a meta-analysis.Lipids in health and disease · 2023 · on this map
    Pooled it
  8. Pravastatin for lowering lipids.The Cochrane database of systematic reviews · 2023 · on this map
    Pooled it
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  15. Prevalence of statin intolerance: a meta-analysis.European heart journal · 2022 · on this map
    Pooled it
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950 more citing papers are in PubMed but not listed here.

6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group
University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundIn patients with coronary heart disease and a broad range of cholesterol levels, cholesterol-lowering therapy reduces the risk of coronary events, but the effects on mortality from coronary heart disease and overall mortality have remained uncertain.

methodsIn a double-blind, randomized trial, we compared the effects of pravastatin (40 mg daily) with those of a placebo over a mean follow-up period of 6.1 years in 9014 patients who were 31 to 75 years of age. The patients had a history of myocardial infarction or hospitalization for unstable angina and initial plasma total cholesterol levels of 155 to 271 mg per deciliter. Both groups received advice on following a cholesterol-lowering diet. The primary study outcome was mortality from coronary heart disease.

resultsDeath from coronary heart disease occurred in 8.3 percent of the patients in the placebo group and 6.4 percent of those in the pravastatin group, a relative reduction in risk of 24 percent (95 percent confidence interval, 12 to 35 percent; P<0.001). Overall mortality was 14.1 percent in the placebo group and 11.0 percent in the pravastatin group (relative reduction in risk, 22 percent; 95 percent confidence interval, 13 to 31 percent; P<0.001). The incidence of all cardiovascular outcomes was consistently lower among patients assigned to receive pravastatin; these outcomes included myocardial infarction (reduction in risk, 29 percent; P<0.001), death from coronary heart disease or nonfatal myocardial infarction (a 24 percent reduction in risk, P<0.001), stroke (a 19 percent reduction in risk, P=0.048), and coronary revascularization (a 20 percent reduction in risk, P<0.001). The effects of treatment were similar for all predefined subgroups. There were no clinically significant adverse effects of treatment with pravastatin.

conclusionsPravastatin therapy reduced mortality from coronary heart disease and overall mortality, as compared with the rates in the placebo group, as well as the incidence of all prespecified cardiovascular events in patients with a history of myocardial infarction or unstable angina who had a broad range of initial cholesterol levels.

Indexed as

AdultAgedAnticholesteremic AgentsCardiovascular DiseasesCoronary DiseaseDouble-Blind MethodFemaleHumansIncidenceLipidsMaleMiddle AgedMortalityMyocardial InfarctionPravastatinRiskAnticholesteremic AgentsLipidsPravastatin

Identifiers

PMID9841303
OpenAlexW38523360

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

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.