The 4S study. Implications for prescribing.
Drugs
; 51(4): 507-14, 1996 Apr.
Article
em En
| MEDLINE
| ID: mdl-8706591
ABSTRACT
This article discusses various aspects of cholesterol-lowering therapy using the HMG-CoA reductase inhibitor simvastatin in the light of the large Scandinavian Simvastatin Survival Study (4S). In 4S, patients with proven coronary heart disease (CHD) and plasma total cholesterol > 5.5 mmol/L (212 mg/dl) despite dietary measures received statin therapy or placebo for > or = 5 years. A significant mortality reduction was accomplished in those receiving the statin. Moreover, a significant decrease of nonfatal myocardial infarction and requirement for coronary bypass surgery or angioplasty was demonstrated, which will contribute to the cost-effectiveness of this well tolerated therapy. Plaque stabilisation and improvement of endothelial function are thought to be mediators of this therapeutic success. Responsible drug prescription in the post-4S era may result in the recognition and treatment of more patients with CHD. This is likely to be more beneficial than exhaustive efforts to completely achieve the goals of the most strict guidelines in the individual patient. In patients who carry the highest absolute risk for a recurrent event, aggressive drug therapy may be most justified. Reluctance to initiate lipid lowering drug therapy in patients with proven CHD should now be disputed.
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Base de dados:
MEDLINE
Assunto principal:
Lovastatina
/
Colesterol
/
Inibidores de Hidroximetilglutaril-CoA Redutases
/
Doença das Coronárias
/
Anticolesterolemiantes
Tipo de estudo:
Clinical_trials
/
Guideline
/
Observational_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
1996
Tipo de documento:
Article