Prevention

using a statin ^a , particularly for patients revascularised following post-infarct angina. ^a

Why?

• Statins do reduce mortality, particularly from myocardial infarction. ^a

Pravastatin reduces MI or invasive therapy in patients with cholesterol levels < 6.2 mmol/l

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
MI or unstable angina and cholesterol levels 4.0-7.0 mmol/l a	pravastatin	placebo	death at 6 years	14%	22% (12% to 30%)	33 231 to 60)
			hospitalisation with unstable angina at 6 years	25%	9% (2% to 16%)	44 (25 to 180)

• Aggressive lipid-lowering following a CABG slows restenosis ^a , reduces cardiac events (death, MI, stroke, revascularisation) and the need for further revascularisation. ^a

Aggressive lowering of cholesterol reduces revascularisation following CABG

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
CABG a	aggressive cholesterol-lowering	moderate cholesterol-lowering	cardiac events at 7.5 years	40%	21% (9% to 32%)	12 (7 to 30)
			PTCA or CABG at 7.5 years	19%	29% (14% to 42%)	12 (8 to 28)

• Statin therapy becomes more cost-effective as the number of cardiovascular risk factors present increase ^{a b}