Skip Navigation

European Heart Journal 1998 19(10):1531-1537; doi:10.1053/euhj.1998.1191
Copyright © 1998 by the European Society of Cardiology.
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (3)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Faergeman, O.
Right arrow Articles by Pedersen, T.R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Faergeman, O.
Right arrow Articles by Pedersen, T.R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Differences in the treatment of coronary heart disease between countries as revealed in the Scandinavian Simvastatin Survival Study (4S)

O. Faergemana, J. Kjekshusb, T. Cookc, K. Pyöräläd, L. Wilhelmsene, G. Thorgeirssonf and T.R. Pederseng

a Department of Medicine and Cardiology, Aarhus Amtssygehus, Aarhus, Denmark
b Department of Medicine, Rikhospitalet, Oslo, Norway
c Merck Research Laboratories, Rahway, New Jersey, U.S.A.
d Department of Internal Medicine, University of Kuopio, Kuopio, Finland
e Section of Preventive Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden
f Landspitalinn University Hospital, Reykjavik, Iceland
g Medical Clinic, Aker Hospital, Oslo, Norway

accepted June 3, 1998

Aim To assess differences in treatment of ischaemic heart disease in the Scandinavian countries.

Methods and Results The Scandinavian Simvastatin Survival Study (4S) lasted 5·4 years and showed that death rates in 4444 patients with coronary heart disease were 30% lower in those treated with simvastatin to lower serum cholesterol than in those given placebo. Apart from this main result, the 4S provided detailed information on rates of death and other manifestations of coronary heart disease, as well as on use of non-lipid forms of therapy. There were substantial differences in 4S placebo group rates of mortality, coronary deaths and major coronary events between countries. Surgical and medical therapy varied importantly between countries.

Conclusions Major inter-country differences in rates of death and myocardial infarction in patients with coronary heart disease were likely to be due to a composite of differences in baseline characteristics including smoking. They occurred in a setting of very uneven exploitation of the potential for improving survival of patients with ischaemic heart disease.

Key Words: Coronary heart disease • cholesterol • medical technology • smoking • beta-blockade • calcium channel blockers • revascularization

Correspondence:Ole Faergeman, MD, Department of Medicine and Cardiology, Aarhus Amtssygehus University Hospital, DK-8000 Aarhus C, Denmark.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CirculationHome page
S. H. Rahimtoola, A. Durairaj, A. Mehra, and I. Nuno
Current Evaluation and Management of Patients With Mitral Stenosis
Circulation, September 3, 2002; 106(10): 1183 - 1188.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.