4S

About the Trial

The Scandinavian Simvastatin Survival Study randomized 4,444 patients with prior heart attack or angina and high cholesterol to simvastatin or placebo. Over 5.4 years, simvastatin reduced all cause mortality by 30 percent and major coronary events by 34 percent. This was the first statin trial with mortality benefit, ending the debate about whether lowering cholesterol helps. Coronary artery disease transformed from an untouchable degenerative disease into a treatable condition. The 4S results made statins among the most prescribed drug classes in history and established LDL cholesterol as the central target of cardiovascular prevention.