Cholesterol: Near miss in Edinburgh

Just another brief post. This group were very, very, very lucky. Crucifiction is supposed to be unpleasant.

What did they do? Well it was more of the usual stuff but, back in the early years of this century, it was still considered ethical to include a placebo group in a statin trial! Gasp, horror, call the ethics committee.

Anyway, 54 people, all with known heart disesae, were allowed to go for 24 months without the benefit of atrovastatin. You wouldn't do this in the states! But here in Scotland, well, a few more heart attacks and no one will notice.

So what does a greater than 50% reduction of LDL-C and a near 50% reduction in C reactive protein do for CAC score progression?

Diddley squat, as you would expect. It's all the usual quotes:

"statin treatment does not have a major effect on the rate of progression of coronary artery calcification"

and

"Serum low density lipoprotein concentrations were not correlated with the rate of progression of coronary calcification (r = 0.05, p = 0.62)"

All utterly tedious.

What grabbed me was the near miss. The CAC score progression in the atrovastatin group was not significantly different to the placebo group.

The p value was 0.18

What would have happened if the p had cracked the mystical p<0.05, say with bigger groups or longer follow up?

In this study atrovastatin "allowed" or "facilitated" progesssion by 26% per year, placebo by only 18% per year.

As I say, p=0.18

A near miss for the careers of all involved.

Peter

Oh, and in the full text you can find that there were actually 2 diabetic patients and 10 current smokers in the placebo group vs no diabetics and only 5 current smokers in the statin group. Equalising these might have given catastrophe.