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Cholestanol and survival with simvastatin

BMJ 1998; 317 doi: (Published 31 October 1998) Cite this as: BMJ 1998;317:1252

More data are needed

  1. EJ Wallis, Research assistant,
  2. R Williamson, Lecturer,
  3. LE Ramsay, Professor,
  4. W W Yeo, Senior lecturer,
  5. P R Jackson, Reader
  1. Department of Clinical Pharmacology and Therapeutics, Royal Hallamshire Hospital, Sheffield S10 2JF
  2. Department of Medicine, University of Helsinki, PO Box 340, FIN-00029 HYKS, Helsinki, Finland
  3. Department of Public Health, University of Helsinki

    EDITOR—Miettinen and colleagues identify a subgroup of Finnish patients with high cholestanol ratios who gained no benefit from statin treatment.1 They suggest that such patients have a low rate of cholesterol synthesis but a high rate of cholesterol absorption and that drugs that block the synthesis of cholesterol therefore do not improve survival.

    Surprisingly, they presented no data on the falls in serum cholesterol concentrations observed with simvastatin treatment within each cholestanol quarter. This information is essential to fully understand the link between high cholestanol ratio and the smaller reduction …

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