Simvastatin Improves Survival; 4S Study

Long-term treatment with Merck & Co's cholesterol-lowering drug simvastatin is safe and improves survival in patients with coronary heart disease, according to the results of the Scandinavian Simvastatin Survival Study (4S) which have been published in The Lancet (November 19). A total of 4,444 patients with angina pectoris or previous myocardial infarction and serum cholesterol of 5.5-8.0 mmol/l were randomized to treatment with simvastatin or placebo. Patients were followed up for a median of 5.4 years.

Simvastatin reduced total cholesterol and low-density lipoprotein cholesterol by 25% and 35% respectively, and increased protective high-density lipoprotein levels by 8%. Few adverse events were encountered. 12% of patients in the placebo group died, compared to 8% in the pravastatin group, with a relative risk of death for the latter group of 0.70. For coronary deaths the relative risk was 0.58.

KAPS Prevention Trial Meantime, the first prevention trial of Bristol-Myers Squibb's HMG-CoA reductase inhibitor Pravachol (pravastatin) has shown a 45% slowing in the progression of atherosclerotic disease. Previous studies with the drug involved patients who already had either severe coronary heart disease, severe atherosclerosis or prior myocardial infarction.