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document
Effect of pravastatin on cardiovascular events in women after myocardial infarction : the cholesterol and recurrent events ( CARE ) trial . OBJECTIVES We sought to determine the effect of pravastatin on recurrent cardiovascular events in women with average cholesterol levels after myocardial infarction ( MI ) . BACKGROUND Little information is available on the effectiveness of lipid lowering in secondary prevention of coronary heart disease ( CHD ) in women ; in particular , those with CHD and average cholesterol levels . METHODS In the Cholesterol and Recurrent Events ( CARE ) trial , 576 postmenopausal women , between 3 and 20 months after MI , with a total cholesterol level < 240 mg/dl and a low density lipoprotein cholesterol level 115 to 174 mg/dl , were randomized to receive pravastatin 40 mg/day or matching placebo for a median follow-up period of 5 years . The main outcome measures were combined coronary events ( coronary death , nonfatal MI , percutaneous transluminal coronary angioplasty [ PTCA ] or coronary artery bypass graft surgery [ CABG ] ) , the primary trial end point ( coronary death or nonfatal MI ) and stroke . RESULTS Women treated with pravastatin had a risk reduction of 43 % for the primary end point ( p = 0.035 ) , 46 % for combined coronary events ( p = 0.001 ) , 48 % for PTCA ( p = 0.025 ) , 40 % for CABG ( p = 0.14 ) and 56 % for stroke ( p = 0.07 ) . The 3,583 men in the CARE trial also showed a reduction in risk , but the magnitude tended to be less . Pravastatin improved plasma lipids similarly in men and women . There were no differences in risk of coronary events in the placebo group between men and women . Minor differences between men and women were present in baseline characteristics and treatment for MI , in general , conferring a higher risk status and a lower incidence of CABG in the women . CONCLUSIONS Pravastatin led to significant early reduction of a wide range of cardiovascular events in post-MI women with average cholesterol levels .
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Intervention_Pharmacological
pravastatin
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Intervention_Pharmacological
pravastatin
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Intervention_Pharmacological
pravastatin 40 mg/day
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Intervention_Control
placebo
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Intervention_Pharmacological
Pravastatin
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Intervention_Pharmacological
Pravastatin
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Outcome_Physical
cardiovascular events
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Outcome_Physical
recurrent cardiovascular events
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Outcome_Physical
combined coronary events ( coronary death , nonfatal MI , percutaneous transluminal coronary angioplasty [ PTCA ] or coronary artery bypass graft surgery [ CABG ] ) , the primary trial end point ( coronary death or nonfatal MI ) and stroke
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Outcome_Physical
risk reduction
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Outcome_Physical
risk
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Outcome_Physical
plasma lipids
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Outcome_Physical
risk of coronary events
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Participant_Condition
women after myocardial infarction :
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Participant_Condition
women with average cholesterol levels after myocardial infarction ( MI ) .
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Participant_Condition
coronary heart disease ( CHD ) in women ; in particular , those with CHD and average cholesterol levels .