Pravastatin reduces the incidence of cardiac events among patients with myocardial intarction

We retrospectively compared the incidence of cardiac events in myocardial infarction (M I) patients treated in our departments between 1990 and 1999 with pravastatin or without cholesterol-lowering.,, agents. Our aim was to evaluate the efficacy of pravastatin in the secondary prevention of MI. Cardiac events-defined as fatal or nonfatal recurrent NIL sodden cardiac death, and death from congestive heart failure -occurred in S (2.2%) of 356 MI patients treated with pravastatin (17.1 cases/1,000 person (.) year) and in 39 (5.6%) of 700 MI patients not treated with cholesterol-lowering agents (54.3 cases/1,000 person year), which represented a significant decline among (hose taking pravastatin (P < 0.05. odds ratio : 0.39, 95% Cl: 0.18-0.84). Likewise, total mortality was significantly lower among patients treated with pravastatin (18 cases, 5-1% : 38.4 cases/1,000 person (.) year vs 77 cases, 11.0%; 107.2 cases/1,000 person (.) year, P < 0.01, odds ratio : 0.43, 95% Cl: 0.25-0.73). Subgroup analysis revealed a significantly lower incidence of cardiac events in the pravastatin group for 6 of the items among 53 patient characteristics. and was lower but not significant for 45 items and was greater but not significant only for 2 items Furthermore, multivariate analysis confirmed pravastatin to be a useful factor for preventing the occurrence of cardiac events in M I patients (P < 0.05. odds ratio: 0.44. 95% Cl: 0.20-0.95). and Kaplan-Meier curves also showed pravastatin to significantly reduce the incidence of both cardiac events,and total mortality. These findings are consistent with those previously reported by several large-scale clinical trials carried out-in Western countries. and demonstrate that pravastatin is useful for secondary prevention of A in Japanese patients.