Trial reportJournal of the American Geriatrics Society2014
Homocysteine levels and treatment effect in the PROspective Study of Pravastatin in the Elderly at Risk.
Trial report in Journal of the American Geriatrics Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Sources of Heterogeneity in the Efficacy of Statins for Primary Prevention of Cardiovascular Diseases: A Systematic Review with Meta-Regression and Meta-Analysis of Within-Study Subgroup Differences.Cardiovascular drugs and therapy · 2026Pooled it
- Systematic review regarding metabolic profiling for improved pathophysiological understanding of disease and outcome prediction in respiratory infections.Respiratory research · 2015Pooled it
- Safety and efficacy of low-density lipoprotein-lowering drugs in the elderly: a network meta-analysis of randomized controlled trials.Journal of geriatric cardiology : JGC · 2026Article
- Association of plasma homocysteine with cardiovascular disease in American adults: a study based on the national health and nutrition examination survey database.Frontiers in cardiovascular medicine · 2025Article
- Non-Conventional Risk Factors: "Fact" or "Fake" in Cardiovascular Disease Prevention?Biomedicines · 2023Review
- Homocysteine, hypertension, and risks of cardiovascular events and all-cause death in the Chinese elderly population: a prospective study.Journal of geriatric cardiology : JGC · 2021Article
- Coronary Microvascular Endothelial Dysfunction in Patients With Angina and Nonobstructive Coronary Artery Disease Is Associated With Elevated Serum Homocysteine Levels.Journal of the American Heart Association · 2020Article
- Gender-Specific Differences in Concentrations of Biochemical Parameters in Persons over the Age of 90.International journal of environmental research and public health · 2019Article
- Role of Statin Therapy in Primary Prevention of Cardiovascular Disease in Elderly Patients.Current atherosclerosis reports · 2019Review
- Hyperhomocysteinemia as a metabolic disorder parameter is independently associated with the severity of coronary heart disease.Saudi medical journal · 2015Article
- Dietary methionine restriction in mice elicits an adaptive cardiovascular response to hyperhomocysteinemia.Scientific reports · 2015Article
- Cardiorheumatology: cardiac involvement in systemic rheumatic disease.Nature reviews. Cardiology · 2015 · on this mapReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the effect of preventive pravastatin treatment on coronary heart disease (CHD) morbidity and mortality in older persons at risk for cardiovascular disease (CVD), stratified according to plasma levels of homocysteine.
designA post hoc subanalysis in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), started in 1997, which is a double-blind, randomized, placebo-controlled trial with a mean follow-up of 3.2 years.
settingPrimary care setting in two of the three PROSPER study sites (Netherlands and Scotland).
participantsIndividuals (n = 3,522, aged 70-82, 1,765 male) with a history of or risk factors for CVD were ranked in three groups depending on baseline homocysteine level, sex, and study site.
interventionPravastatin (40 mg) versus placebo. MEASUREMENTS: Fatal and nonfatal CHD and mortality.
resultsIn the placebo group, participants with a high homocysteine level (n = 588) had a 1.8 higher risk (95% confidence interval (CI) = 1.2-2.5, P = .001) of fatal and nonfatal CHD than those with a low homocysteine level (n = 597). The absolute risk reduction in fatal and nonfatal CHD with pravastatin treatment was 1.6% (95% CI = -1.6 to 4.7%) in the low homocysteine group and 6.7% (95% CI = 2.7-10.7%) in the high homocysteine group (difference 5.2%, 95% CI = 0.11-10.3, P = .046). Therefore, the number needed to treat (NNT) with pravastatin for 3.2 years for benefit related to fatal and nonfatal CHD events was 14.8 (95% CI = 9.3-36.6) for high homocysteine and 64.5 (95% CI = 21.4-∞) for low homocysteine.
conclusionIn older persons at risk of CVD, those with high homocysteine are at highest risk for fatal and nonfatal CHD. With pravastatin treatment, this group has the highest absolute risk reduction and the lowest NNT to prevent fatal and nonfatal CHD.
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