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- Title
Meta-analysis of large randomized controlled trials to evaluate the impact of statins on cardiovascular outcomes.
- Authors
Cheng, Bernard M.Y.; Lauder, Ian J.; Chu-Pak Lau; Kumana, Cyrus R.
- Abstract
Aims Since 2002, there have been five major outcome trails of statins reporting findings from more than 47 000 subject. As individual trial result differed, we performed a meta-analysis to ascertain the effectiveness safety of statin overall and in subgroups. The aim of the study was to estimate effect of statins on major coronary events and strokes, all-cause mortality and noncardiovascular mortality, and in different subgroups. Metheds. PubMed was searched for trial published in English. Randomized placebo-controlled statin trails with average follow up of at least 100 major coronary events were included. For each trial, the used, number and type of subjects, proportion of women, mean age follow up, baseline and change in lipid profile, cardiovascular and non-cardiovascular outcomes were recorded. Results. Ten trial involving 79 494 subject were included in the meta-analysis. Due to heterogeneity, ALLHAT-LLT was excluded from some analyses. Statin therapy reduced major coronary event by 27% (95%CI 23,30%), stroke by 18% (95%CI 10,25%)and all-cause mortality by 15% (95%CI 8,21%).There was a 4% (95%CI-10,3%) nonsignificant reduction in noncardiovascular mortality. The reduction in major coronary events ids independent of gender and presence of hypertension or diabetes. The risk reduction was greater in smokers (P<0.05).Coronary events were reduced by 23% (95%CI 18,29%) in pravastatin trials and 29% (95%Ci 25,33%) in five trials using other statins. Pravastatin reduce stroke by 12% (95%CI 1,21%) whilst other statins reduced strokes by 24% (95%CI 16,32%)(P=0.04).Conclusion.Statins reduce coronary event, strokes and all-cause mortality without increasing noncoronary mortality. the benefits accue in men and women, hypertensives and nonmotensives, diabetics and nondiabetics, and particularly in smokers. pravastatin appears to have less impact on strokes.
- Publication
British Journal of Clinical Pharmacology, 2004, Vol 57, Issue 5, p640
- ISSN
0306-5251
- Publication type
Academic Journal
- DOI
10.1111/j.1365-2125.2003.02060.x