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November 26, 1997

Cholesterol Lowering With Statin Drugs: Evidence in Women

Author Affiliations

Beth Israel Deaconess Medical Center Boston, Mass

JAMA. 1997;278(20):1660. doi:10.1001/jama.1997.03550200036024

To the Editor.  —The article by Dr Hebert and colleagues,1 which reviewed acute cardiovascular events and deaths in trials of statin drugs, does not comment on the outcome of the female patients included in these trials. Of the 13 secondary prevention trials, 1 included no female patients, and only 3 (Expanded Clinical Evaluation of Lovastatin [EXCE L], Scandinavian Simvastatin Survival Study [4S], and Cholesterol and Recurrent Events [CARE]) enrolled more than 100 female patients and followed up patients for more than 1 year. The EXCEL trial2,3 enrolled approximately 3389 female patients and the follow-up period was 48 weeks. However, patients were divided into 5 treatment groups, with no significant differences in adverse outcomes between the groups. No power calculation was performed and the authors did not report data on female patients separately. A total of 827 female patients were enrolled in the 4S study,4 with a