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

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dc.contributor.author Lloyd, Suzanne M.
dc.contributor.author Stott, David J.
dc.contributor.author de Craen, Anton J. M.
dc.contributor.author Kearney, Patricia M.
dc.contributor.author Sattar, Naveed
dc.contributor.author Perry, Ivan J.
dc.contributor.author Packard, Christopher J.
dc.contributor.author Briggs, Andrew
dc.contributor.author Marchbank, Laura
dc.contributor.author Comber, Harry
dc.contributor.author Jukema, J. Wouter
dc.contributor.author Westendorp, Rudi G. J.
dc.contributor.author Trompet, Stella
dc.contributor.author Buckley, Brendan M.
dc.contributor.author Ford, Ian
dc.date.accessioned 2014-04-04T15:01:00Z
dc.date.available 2014-04-04T15:01:00Z
dc.date.issued 2013-09-02
dc.identifier.citation LLOYD, S. M., STOTT, D. J., DE CRAEN, A. J. M., KEARNEY, P. M., SATTAR, N., PERRY, I., PACKARD, C. J., BRIGGS, A., MARCHBANK, L., COMBER, H., JUKEMA, J. W., WESTENDORP, R. G. J., TROMPET, S., BUCKLEY, B. M. & FORD, I. 2013. Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). PLoS ONE 8(9): e72642. doi:10.1371/journal.pone.0072642 en
dc.identifier.volume 8 en
dc.identifier.issued 9 en
dc.identifier.startpage e72642 en
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10468/1508
dc.identifier.doi 10.1371/journal.pone.0072642
dc.description.abstract Background The 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. Methods: 5,804 (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). Results: Pravastatin 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). Conclusions: Pravastatin 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. en
dc.description.sponsorship Wellcome Trust, United Kingdom (Scottish Health Informatics Programme)
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science en
dc.rights ©2013 Lloyd et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en
dc.rights.uri http://creativecommons.org/licenses/by/3.0/ en
dc.subject Cancer treatment en
dc.subject Coronary artery disease en
dc.subject Coronary heart disease en
dc.subject Death rates en
dc.subject Elderly en
dc.subject Stroke en
dc.subject Vascular diseases en
dc.title Long-term effects of statin treatment in elderly people: extended follow-up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Patricia Kearney, Epidemiology & Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: patricia.kearney@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2013-11-28T14:36:10Z
dc.description.version Published Version en
dc.internal.rssid 238188722
dc.internal.pmid 24023757
dc.contributor.funder Wellcome Trust, United Kingdom en
dc.contributor.funder Chief Scientist Office, Scotland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Plos One en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress patricia.kearney@ucc.ie en


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©2013 Lloyd et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as ©2013 Lloyd et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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