What's New in Research: March 1, 2004
Previous | Main SCI-BYTES Menu (current year) | 2004 Menu

"MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,356 high-risk
individuals: a randomised placebo-controlled trial," by R. Collins, et al. (the Heart Protection Study
Collaborative Group), The Lancet, 360(9326): 7-22, 6 July 2002.

[Author's affiliations: Multiple U.K. institutions; study based at Radcliffe Infirmary, University of Oxford, U.K.]

From the Summary: "Background Throughout the usual LDL cholesterol range in Western populations, lower
blood concentrations are associated with lower cardiovascular disease risk. In such populations, therefore, reducing LDL cholesterol may reduce the development of vascular disease, largely irrespective of initial cholesterol concentrations. Methods 20 356 UK adults (aged 40-80 years) with coronary disease, other occlusive arterial disease, or diabetes were randomly allocated to receive 40 mg simvastatin daily (average compliance: 85%) or matching placebo (average non-study statin use: 17%). Analyses are of the first occurrence of particular events, and compare all simvastatin-allocated versus all placebo-allocated participants. These "intention-to-treat" comparisons assess the effects of about two-thirds (85% minus 17%) taking statin during the scheduled 5-year treatment period, which yielded an average difference in LDL cholesterol of 1.0 mmol/L (about two-thirds of the effect of actual use of 40 mg simvastatin daily). Primary outcomes were mortality (for overall analyses) and fatal or non-fatal vascular events (for subcategory analyses), with subsidiary assessments of cancer and of other major morbidity....Interpretation Adding simvastatin to existing treatments safely produces substantial additional benefits for a wide range of high-risk patients, irrespective of their initial cholesterol concentrations. Allocation
to 40 mg simvastatin daily reduced the rates of myocardial infarction, of stroke, and of revascularization by about
one-quarter. After making allowance for non-compliance, actual use of this regimen would probably reduce these
rates by about one-third. Hence, among the many types of high-risk individuals studied, 5 years of simvastatin would prevent about 70-100 people per 1000 from suffering at least one of these major vascular events (and longer treatment should produce further benefit). The size of the 5-year benefit depends chiefly on such individuals' overall risk of major vascular events, rather than on their blood lipid concentrations alone."

This 2002 report from The Lancet was cited 73 times in current journal articles indexed in the Thomson ISI
database during November-December 2003. The paper has ranked among the hottest in medicine for several
months now, and its latest two-month total made it the second-most-cited medicine paper published in the last
two years, aside from reviews. Prior to the most recent bimonthly count, citations to the paper have accrued as
follows:

September-October 2003: 98 citations
July-August 2003: 72
May-June 2003: 68
March-April 2003: 86
January-February 2003: 63
November-December 2002: 33
October-November 2002: 11

Total citations to date: 504

Related information:
Top 10 scientists in Clinical Medicine; for the period of January 1, 1993 - October 31, 2003

Previous Page | Return to SCI-BYTES Main Menu | Return to 2004 Menu
If you came from the Thomson Scientific Web site, click here to return
  

in-cites - an editorial component of ISI Essential Science Indicators from ISI^®
Citing URL: http://www.in-cites.com/research/2004/march_1_2004-3.html