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SEARCH. No difference in the incidence of major vascular events between high- vs. low-dose simvastatin, or folate + vitamin B 12 vs. placebo (p > 0.05 for both) No difference in individual outcomes studied

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  1. SEARCH No difference in the incidence of major vascular events between high- vs. low-dose simvastatin, or folate + vitamin B12 vs. placebo (p > 0.05 for both) No difference in individual outcomes studied ↑ risk of myopathy in high-dose vs. low-dose simvastatin arms (0.88% vs. 0.05%, p < 0.05) (p > 0.05) (p > 0.05) Trial design: A 2 x 2 factorial study in which patients with a recent MI were randomized to either simvastatin 80 mg or 20 mg daily, and folic acid + vitamin B12 or placebo. Patients were followed for a mean of 6.7 years. Results 50 50 % % 25.7 24.5 25.5 24.8 0 0 Conclusions Major vascular events • Neither high-dose (vs. low-dose) simvastatin nor folate + vitamin B12 (vs. placebo) effective in reducing major vascular events in patients with a recent MI • Statin data contrary to other trials on this topic, folate + vitamin B12 data similar Folate/ Vit B12 n = 6,033 Simvastatin 80 mg n = 6,031 Simvastatin 20 mg n = 6,033 Placebo n = 6,031 Presented by Dr. Rory Collins at AHA 2008

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