Principal Findings:

Simvastatin patients had a significant 30% relative risk reduction in overall mortality (8.2% vs. 11.5%; p = 0.0003), as well as 39% fewer nonfatal MIs (7.4% vs. 12.1%), 41% fewer ischemic heart disease deaths (5.0% vs. 8.5%), and 34% fewer myocardial revascularization procedures (11.3% vs. 17.2%). There was no difference between the 2 groups in the incidence of noncardiovascular deaths. Simvastatin therapy was associated with 25% lower total cholesterol(TC), 35% lower LDL, and 8% higher HDL levels. Simvastatin reduced the risk of major coronary events in ALL quartiles of baseline lipid lipid levels, including a 35% risk reduction among patients in the lowest quartile of baseline LDL. The overall rates of adverse effects were similar in the two groups. A subsequent cost analysis showed that simvastatin-treated patients had 34% fewer cardiovascular-related hospital days and that there was $3,872 savings/patient, reducing the effective drug cost by 88% to 28 cents/day (see Circulation 1996;93:1796). Other analyses have shown that women, the elderly (>65 years old), and diabetics all had significant reductions in major events (see references below).