Related Experiment Video
Updated: May 2, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention: a
Patrick W J C Serruys1, Pim de Feyter, Carlos Macaya
1Interventional Cardiology, Thoraxcenter, Bd 418, Academic Hospital, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. serruys@card.azr.nl
Insights
Fluvastatin significantly reduces major adverse cardiac events (MACE) in patients after percutaneous coronary intervention (PCI). This statin therapy improves long-term outcomes, lowering the risk of cardiac death, heart attack, or reintervention.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Percutaneous coronary intervention (PCI) offers short-term symptom relief but long-term risks of major adverse cardiac events (MACE) persist.
- Only 60% of PCI patients are MACE-free at 5 years, and only one-third at 10 years.
Purpose of the Study:
- To investigate the efficacy of fluvastatin in reducing MACE in patients post-PCI.
- To assess the impact of fluvastatin on long-term cardiovascular outcomes following successful PCI.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 1677 patients across 77 European, Canadian, and Brazilian centers.
- Patients received either 80 mg/day fluvastatin or a placebo for 3-4 years post-PCI, with MACE defined as cardiac death, nonfatal myocardial infarction, or reintervention.
Main Results:
- Fluvastatin treatment significantly increased MACE-free survival time (P=.01).
- Patients on fluvastatin experienced a 22% reduction in MACE risk (RR 0.78, 95% CI 0.64-0.95).
- Significant risk reduction was observed in diabetic patients and those with multivessel disease.
Conclusions:
- Fluvastatin is effective in reducing the risk of major adverse cardiac events in patients with average cholesterol levels after their first successful PCI.
- The benefits of fluvastatin were consistent regardless of baseline cholesterol levels and particularly pronounced in specific patient subgroups.
Context:
Percutaneous coronary intervention (PCI) is associated with excellent short-term improvements in ischemic symptoms, yet only three fifths of PCI patients at 5 years and one third of patients at 10 years remain free of major adverse cardiac events (MACE).
Objective:
To determine whether treatment with fluvastatin reduces MACE in patients who have undergone PCI.
Design And Setting:
Randomized, double-blind, placebo-controlled trial conducted at 77 referral centers in Europe, Canada, and Brazil.
Patients:
A total of 1677 patients (aged 18-80 years) recruited between April 1996 and October 1998 with stable or unstable angina or silent ischemia following successful completion of their first PCI who had baseline total cholesterol levels between 135 and 270 mg/dL (3.5-7.0 mmol/L), with fasting triglyceride levels of less than 400 mg/dL (4.5 mmol/L).
Interventions:
Patients were randomly assigned to receive treatment with fluvastatin, 80 mg/d (n = 844), or matching placebo (n = 833) at hospital discharge for 3 to 4 years.
Main Outcome Measure:
Survival time free of MACE, defined as cardiac death, nonfatal myocardial infarction, or reintervention procedure, compared between the treatment and placebo groups.
Results:
Median time between PCI and first dose of study medication was 2.0 days, and median follow-up was 3.9 years. MACE-free survival time was significantly longer in the fluvastatin group (P =.01). One hundred eighty-one (21.4%) of 844 patients in the fluvastatin group and 222 (26.7%) of 833 patients in the placebo group had at least 1 MACE (relative risk [RR], 0.78; 95% confidence interval [CI], 0.64-0.95; P =.01). This result was independent of baseline total cholesterol levels (above [RR, 0.76; 95% CI, 0.56-1.04] vs below [RR, 0.77; 95% CI, 0.57-1.02] the median). In subgroup analysis, the risk of MACE was reduced in patients with diabetes (n = 202; RR, 0.53; 95% CI, 0.29-0.97; P =.04) and in those with multivessel disease (n = 614; RR, 0.66; 95% CI, 0.48-0.91; P =.01) who received fluvastatin compared with those who received placebo. There were no instances of creatine phosphokinase elevations 10 or more times the upper limit of normal or rhabdomyolysis in the fluvastatin group.
Conclusion:
Fluvastatin treatment in patients with average cholesterol levels undergoing their first successful PCI significantly reduces the risk of major adverse cardiac events.
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:26Coronary Artery Disease IV: Preventive Measures
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Atherosclerosis III: Management