4S Trial
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
4S Trial
Objective
To evaluate the effect of cholesterol lowering with simvastatin on mortality and morbidity in patients with coronary artery disease (CAD).
Methods
The Scandinavian Simvastatin Survival Study (4S) enrolled 4444 patients with known CAD (angina pectoris or previous myocardial infarction) and serum cholesterol levels between 212 and 309 mg/dL. Patients were randomly assigned to either simvastatin (20 to 40 mg/day) or placebo and were followed-up for a median period of 5.4 years.
Results
- Total cholesterol reduced by 25%
- LDL-C levels reduced by 35%
- Mean HDL-C improved by 8%
- Mortality rate was lower in the simvastatin group compared with that in the placebo group (8% vs 12%)
- Significant reductions in major coronary events (19 versus 28 percent)
Conclusion
The study showed that long-term treatment with simvastatin is safe and improves survival in CAD patients.[1]